Phacotrabeculectomy without peripheral iridectomy.

BACKGROUND AND OBJECTIVE

Peripheral iridectomy has been a long established part of glaucoma drainage surgery. This series examines the potential to dispense with iridectomy when trabeculectomy is combined with modern small-incision cataract surgery.

PATIENTS AND METHODS

Twenty-five unselected consecutive patients underwent a standardized phacotrabeculectomy by a single surgeon. Outcome measures included visual acuity, intraocular pressure control, and complication rates. Mean follow-up was 12.2 months.

RESULTS

There were no complications related to lack of peripheral iridectomy. Intraocular pressure was reduced from a mean of 23.4 mm Hg (SD 5.1) to 15.9 (SD 3.8) at 6 months, and 15.4 (SD 3.5) at 12.2 months. There were 2 relative failures of surgery whose IOP reached preoperative targets with additional medical treatment. Best Snellen acuity improved by a mean of 1.5 lines.

CONCLUSIONS

Phacotrabeculectomy without peripheral iridectomy appears to be safe, although we consider that a corneal fistula and careful control of postoperative overdrainage is necessary to allow this. The success rate and lack of complications is good by comparison with other series. This could be related to the absence of release of factors influencing healing at the time of an iridectomy.