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D. S. Monteiro de Barros, R. S. Da Silva, G. A. Siam, M. E. Gheith, D. Lankaranian, E. H. Tittler, J. S. Myers, G. L. Spaeth; Should an Iridectomy Be Routinely Performed as a Part of Trabeculectomy? Two Surgeons' Clinical Experience. Invest. Ophthalmol. Vis. Sci. 2007;48(13):841.
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To investigate the effects of performing peripheral iridectomy (PI) on the outcome of trabeculectomy.
Retrospective chart review of the medical records of 75 patients (75 eyes) who underwent trabeculectomy surgery, with or without PI, who had been followed for more than one year. Data were collected preoperatively, one day post-operatively, on day 30-90 post-operatively, and one to three years post-operatively. The collected data included visual acuity, intraocular pressure, bleb development, post-operative inflammation, and complications.
36 (48%) of the eyes had cataract extraction at the time of trabeculectomy. A PI was performed in 43 cases (57%). Patients that had PI showed more inflammation at day 30-90 than those who did not have PI performed during trabeculectomy (p=0.018 for those having cataract extraction combined with trabeculectomy and p=0.038 for those having trabeculectomy alone). There were no statistically significant differences in intraocular pressure in eyes with or without iridectomy. Post-operative complications were rare in both groups but greater in number in the eyes with PI.
Trabeculectomy performed without PI appears to be as effective in lowering IOP as when performed with PI, but it is a safer procedure, with a lower incidence of post-operative inflammation. It may be advisable not to perform PI in association with trabeculectomy in eyes not predisposed to post-operative shallowing of the anterior chamber or pupillary block.
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