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Yael Azses, Angela Garcés-Valencia, Carolina Prado Larrea, Rafael Castañeda Diez, Jesus Jiménez-Roman; Toric intraocular lens in patients with glaucoma undergoing phacoemulsification and trabeculectomy: two years follow-up. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2943. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the visual acuity, residual astigmatism and control of intraocular pressure of patients with glaucoma undergoing phacoemulsification surgery with toric lens implantation and trabeculectomy during a 2 year follow-up in our hospital.
We conducted a prospective, longitudinal, interventional, comparative case series study. We included 6 patients from March to November 2013 with diagnosis of glaucoma, cataract and astigmatism who underwent phacoemulsification surgery with toric intraocular lens implantation + trabeculectomy. All surgeries where performed by the same surgeon. The main outcomes measured were residual refraction, best corrected visual acuity, control of intraocular pressure (IOP) and mean deviation in the visual field which were collected preoperative and at one and two years after surgery.
We included 6 patients in our study. The mean age was 74 (± 5.13 SD). The average preoperative, one and two years follow-up logMAR visual acuity was 0.99 (± 0.52 SD), 0.29 (± 0.11 SD) 0.44 (± 0.17 SD) respectively. We found a statistically significant improvement in visual acuity during the first and second year (ANOVA p = 0.0054). The average preoperative, one and two years follow-up intraocular pressure was 19.17mmHg (± 8.7 SD),11.0 (± 1.78 SD),12.8 (± 2.4 SD) respectively, with a statistically significant difference between pre and 2 years follow-up IOP (ANOVA p = 0.0017). The average mean deviation of the preoperative, one and two years follow-up visual field was -9.44 (± 4.5 SD), -3.6 (± 9.8 SD), -4.8 (± 10.06 SD) respectively with no statistically significant difference ( ANOVA p = 0.47). Average refractive preoperative, one and two year follow-up astigmatism was -2.29 D (± 0.99 SD), - 1.0 (± 0.9 SD), -0.70 (± 0.57 SD) respectively with a statistically significant difference between pre and 2 year follow-up astigmatism (p = 0.01 ANOVA).
Patients with previous diagnosis of glaucoma and cataracts undergoing toric IOL implantation had good results, decreasing the refractive astigmatism with consequent improvement in visual acuity in postoperative evaluations. Combined surgery achieved a statistically significant decrease in intraocular pressure and showed no progression of the disease.Further studies with a greater number of patients are required to corroborate this findings.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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