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Combined glaucoma-cataract surgery safer through two sites
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LISBON, Portugal – Performing combined glaucoma surgery and phacoemulsification through two incision sites instead of one is easier for the surgeon and produces more predictable outcomes, according to a presenter here.
Speaking at the European Society of Cataract and Refractive Surgeons meeting, Roberto G. Carassa, MD, said performing glaucoma surgery in one position and then shifting sites to perform phaco makes more sense because the surgeon can use techniques he already knows. To do both surgeries at one site means the surgeon must adapt to new techniques.
“(One-site surgery) is quite different compared to standard phaco or standard trabeculectomy,” Dr. Carassa said.
While surgery at one site is faster because the surgeon does not need to change position, Dr. Carassa said he believes this is its only advantage.
By performing filtering surgery at the same site as cataract surgery, “you are dissecting a very well designed scleral corneal tunnel and changing it to make it leaking,” Dr. Carassa said.
“We have evidence that when comparing phaco-trabeculectomy with the results of trabeculectomy alone, trabeculectomy alone has better results,” he said.
Performing each procedure at its own site reduces complications, reduces manipulation of the sclera, provides for safer use of antimetabolites and ensures that postoperative sutures from the glaucoma procedure do not affect the cataract incision, he said.