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Combined phaco-trabeculectomy can help restore central vision
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BOSTON — Combined phacoemulsification and trabeculectomy is effective in getting patients off medication and opening the door for possible filtering surgery, a speaker said here.
"My treatment is to try to get these patients off medications, keep the pressure in the low digits, restore central vision and simultaneously control astigmatism," Marlene Moster, MD, said during Glaucoma Day preceding the American Society of Cataract and Refractive Surgery meeting.
"For me, mild glaucoma means one or two medications and mild visual field loss," Dr. Moster said. "The options there are to take out the cataract alone or combine that with [endoscopic cyclophotocoagulation], canaloplasty or Trabectome (NeoMedix). Why does this work? Because in the future I can go always back and do some kind of filtering surgery if we absolutely need to."
Dr. Moster said her trabeculectomy technique involves application of lidocaine and mitomycin C 24 mg/cc for 1.5 minutes. A rectangular fornix-base conjunctival flap is made at the 12 o'clock position. Cataract removal and IOL insertion are performed through a temporal incision.
She said she uses 10-0 nylon sutures to reduce surgically induced astigmatism and tests the wound for leakage.
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