TY - JOUR AU - Khurana, AK AU - Chawla, U AU - Passi, N AU - Jyoti, A AU - Archana, A AU - Yogesh, A PY - 2011/02/21 Y2 - 2024/03/29 TI - A comparative study of combined small-incision cataract surgery with sutureless trabeculectomy versus trabeculectomy using W-shaped incision JF - Nepalese Journal of Ophthalmology JA - Nep J Oph VL - 3 IS - 1 SE - Original Articles DO - 10.3126/nepjoph.v3i1.4272 UR - https://www.nepjol.info/index.php/NEPJOPH/article/view/4272 SP - 13-18 AB - <strong>Introduction: </strong>Manual small-incision cataract surgery with trabeculectomy is now an acceptable option in the surgical management of combined cataract and glaucoma uncontrolled with maximum tolerated medical therapy. <br /><br /><strong>Objective:</strong> To compare the results and complications of combined manual small-incision cataract surgery (SICS) and posterior chamber intraocular lens (PCIOL) implantation with trabeculectomy by sutureless versus W-shaped incision technique. <br /><br /><strong>Materials and methods: </strong>The study included 30 eyes of 28 patients with senile cataract and primary open-angle glaucoma (POAG) who were randomly divided into two groups. The patients in Group A (n = 15) underwent SICS with sutureless trabeculectomy and those in Group B (n =15) underwent SICS with trabeculectomy using W-shaped incision with one suture. Post-operative evaluation was done at the first post-operative day and thereafter on follow-ups at 1 week, 2 weeks, 4 weeks and 8 weeks. <br /><br /><strong>Results:</strong> The mean preoperative and postoperative intraocular pressure (IOP) in Group A was 27.33 &plusmn; 3.35 mmHg and 16.13 &plusmn; 4.30 mmHg respectively and in Group B it was 29.46 &plusmn; 6.06 mmHg and 14.66 &plusmn; 2.69 mmHg respectively. The mean reduction in IOP after 8 weeks of follow-up in Group A was 12.52 &plusmn; 3.59 mmHg and that in Group B was 16.47 &plusmn; 3.79 mmHg (p &lt;0.001). Besides this, the uncorrected visual acuity (UCVA) was better in Group B postoperatively with less surgically-induced against-the-rule (ATR) astigmatism. <br /><br /><strong>Conclusion: </strong>Combined SICS with trabeculectomy using W-shaped incision offers better prospective in terms of glaucoma control and visual performance than sutureless combined surgery. <br /><br /><strong>Key words:</strong> sutureless trabeculectomy; combined surgery; W-shaped trabeculectomy<br /><br />DOI: 10.3126/nepjoph.v3i1.4272<br /><br /><em>Nepal J Ophthalmol</em> 2011;3(5):13-18 <br /> ER -