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AbstractDO.16.08 Minimal invasive cataract surgery (MICS) combined with trabeculectomy (MICS-Trab). A pilotstudy of a new combined surgical approach. Thieme H., Kurz S., Nameh A., Pfeiffer N.
Augenklinik und Augenpoliklinik, Johannes Gutenberg-Universität, Mainz Objective: So far there is no real evidence, whether or not the combined or single approach in trabeculectomy and phacoemulsification is of benefit. Aim of this pilot study is to evaluate the performance and safety of a new combined surgical procedure taking the newest IOL designs into account.
Methods: In this study a standard fornix based trabeculectomy with Mitomycin C was combined with a phacoemulsification (MICS-technique) through a 1.8 mm clear cornea paracenthesis. The trabeculectomy was positioned in the 12 o'clock position whereas the two paracentheses (1,5 and 1.8 mm respectively) were located in the 10 and 2 o'clock position, away from the scleral flap which was fixated using a total of four 10-0 Nylon sutures. In all cases the Akreos MI60 IOL was implanted. A total of 10 Patients were included in the study and had a combined surgical procedure. During follow up the patients were evaluated in respect to visual acuity, IOP, complications and other parameters.
Results: Average age of the patients was 76.6 (4 female / 6 male). All had significant cataract and were suffering from PEX-glaucoma (3), primary open angle glaucoma (5) and narrow angle glaucoma (2). An average of 2.6 anti glaucoma medications were prescribed before the operation. Intraoperatively no complications were encountered. IOP could be lowered to a mean of 10.2 mm HG (pre-operatively 24.1) with a mean of 5.8 5-FU-injections (range 1 to 12) and 1.3 suturelysis (range 0-3) nessecary to achieve this IOP. There were no postoperative hypotonies. In one patient an early needling (within 2 weeks after the operation) was required.
Conclusions: MICS-Trab appears to be a safe combined surgical procedure for trabeculectomy and phacoemulsification. It can effectively be used in patients who need a combined approach. Further studies are required in order to assess the long term results of this new technique.
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