Abstract
Purpose:
<br /> To evaluate the keratometric, refractive and visual outcomes in glaucoma patients who underwent phacoemulsification with toric intraocular lens implant and trabeculectomy assisted with femtosecond laser technology.
Methods:
<br /> A prospective, longitudinal and interventional study design in which seven glaucoma patients, with astigmatism over 1 diopter, candidates for cataract phacoemulsification and trabeculectomy without MMC where operated using femtosecond laser technology (Alcon LenSx) with toric intraocular lens (IOL SN6A T3-T6) implantation by one surgeon (RCD). Toric IOL power was calculated using the online calculator provided by the manufacturer considering the average induced astigmatism of the surgeon (-0.43± 0.43 D). Follow up visits were appointed at 1, 3, 6 and 12 months after the procedure; keratometric and refractive astigmatism, visual acuity and intraocular pressure were assessed on months 3 and 12.
Results:
<br /> Seven eyes of seven patients were included (3 male; 4 female) of which 5 patients completed follow up. Mean age was 71.7 (±7.65 DS; range 58-80). Mean uncorrected visual acuity (UCAV) was 0.31 and 0.2 LogMar at 3 and 12 months respectively with statistically significant improvement (p= 0.024). Best corrected visual acuity (BCVA) was 0.11 and 0.4 (±0.2 DS) LogMar at 3 and 12 months follow up. The mean keratometric astigmatism was found to be -1.64 at the 3 month interval and -1.95 (±0.97 DS) at 12 months, with a mean axis of 92.860 and 790 (± 31.1 DS), respectively. Mean refractive astigmatism was 1.11 and -0.85 (±0.85 DS) at 3 and 12 months; with a mean axis of 57.140 at 3 months and 410 (±37.64 DS) a year after the surgery. Mean IOP measurements were 14 mmHg at 3 months the and 10 mmHg one year after the surgery.
Conclusions:
<br /> There was improvement of visual acuity and lower IOP levels at 3 and 12 months follow up of patients implanted with toric IOL during phacoemulsification and trabeculectomy surgery assisted with femtosecond laser. Four out of the five patients with complete follow-up registered lower refractive astigmatism on the last visit.