Clinical Research Of 1.8mm Coaxial Microincision Phacoemulsification And Intraocular Lens Implantation Combined With Trabeculectomy For Treatment Of Glaucoma Complicated With Cataract

Objective To evaluate the effect and safety of 1.8mm coaxial microincision phacoemulsification-trabeculetomy with ultra-thin IOL implants for treating glaucoma complicated with cataract, and compared with the traditional 3.0mm small phacoemulsification-trabeculetomy with foldable IOL implantion.Methods It was a prospective case control study. Collected 60 cases(60 eyes) with glaucoma and cataract patients in Inner Mongolia Autonomous Region People’s Hospital. Divided them randomly into 2 groups. There were 30 cases( 30 eyes) in each group. The small incision group: 30 cases( 30 eyes) underwent 3.0mm coaxial incision phacoemulsification-trabeculetomy with foldable IOL implantation. While microincision group: 30 cases( 30 eyes) underwent 1.8mm microincision phacoemulsification-trabeculetomy with ultra-thin IOL implantation. Follow-up exams were performed on 1 week, 1 month and 3 months after surgery. The preoperative and postoperative visual acuity, corneal endothelial cell density, surgically induced astigmatism, intraocular pressure, filtering bleb and complications were assessed for the two groups.Results At 1 week postoperatively, visual acuity in the microincision group is better than the small incision group, the difference was statistically significant(p<0.05). At 1 month and 3 months, the difference in corrected visual acuity between the 2 groups had no significant difference(p>0.05). At 3days, 1week, 1 and 3months, there was a significant difference between the 2 groups in surgically induced astigmatism(p<0.05). As 3days postoperatively, there was a significant difference in corneal endothelial cells density between 2 groups(p<0.05).But there were no significant difference at 1 and 3 months(p>0.05). The intraocular pressure after surgery in microincision group was 15.26±3.12 mm Hg, and which was 14.57±2.86 mm Hg in small incision group. There was no significance difference between the 2groups(p>0.05). There was no significant difference between the 2groups in blebs(p>0.05). Neither iris injury, posterior capsule rupture nor anterior chamber bleeding complications was found in any group.Conclusion The 1.8mm microincision phacoemulsification-trabeculectomy with ultra-thin IOL implantation and traditional 3.0mm coaxial small incision phacoemulsification-trabeculectomy with foldable IOL implantation were compared, The 1.8mm microincision phacoemulsification-trabeculectomy with ultra-thin IOL implantation can effectively reduce the astigmatism operation. This operation is a safe, effective, convenient surgery for treating cataract and glaucoma.