RESUMO
OBJECTIVE: To explore the clinical efficacies of scleral tunnel sutureless trabeculectomy plus phacoemulsification and intraocular lens implantation in the treatment of glaucoma and cataract. METHODS: A total of 49 cataract patients with glaucoma (52 eyes) from our hospital during the period of February 2009 to June 2012. Their visual acuities were < 0.3 and intraocular pressure was not desirable or in need of various ocular hypotensive drugs. A phaco tunnel knife was employed to prepare a 4 mm × 4 mm scleral tunnel flap with 1/2-2/3 whole layer of sclera depth. Phacoemulsification instrument was used to emulsify cataracts. Foldable intraocular lens was implanted. A trabecular cut of 2 mm × 1.5 mm was made under the scleral tunnel. Tile scleral flap was not sutured and conjunctival flap tightly closed. RESULTS: After a 12-month follow-up, > 0.5 in 42 eyes (80.8%). The intraocular pressure was 11.32 - 17.63 mm Hg (1 mm Hg = 0.133 kPa) and the mean intraocular pressure (13.59 ± 4.26) mm Hg. There was a mean pressure reduction of 11.2 mm Hg from (24.53 ± 5.71) mm Hg pre-operation. Statistical significance existed (t' = 11.073, P < 0.01). The filtering blebs of type I-II was 43 eyes (82.6%) and the mean central anterior chamber 3.28 mm ± 0.42 mm. There was statistical difference (t' = 20.486, P < 0.01) with (1.79 ± 0.31) mm at pre-operation. On 52 eyes, the mean postoperative astigmatism was (1.01 ± 0.62) D versus (1.13 ± 0.74) D at pre-operation. There was no statistical significance (F = 2.0673, P > 0.05). No severe complication occurred in all cases. CONCLUSION: Compared with traditional trabeculectomy and triple procedure, this improved and updated procedure lowers intraocular pressure, improves visual acuity and decreases the occurrences of complications. It is a safe, reasonable, quick and effective treatment for cataract patients with glaucoma.
