Phaco-Deep Sclerectomy With Mitomycin  C Versus Phaco-Trabeculectomy in Patients With Coexisting Cataract and Glaucoma

Adel A. Razek, Adel A. Shalaby, El Sadek A. Maaly and Yasser E. Elazhary

Department of Ophthalmology, Zagazig University, M.D. , Zagazig - 44519 Egypt.

ABSTRACT: Purpose To compare the outcomes of phaco-deep scelerectomy (P-DS) augmented with mitomycin C with phaco-trabeculectomy (P-T) principally regarding the effect on the intraocular pressure (IOP). Methods Fifty eyes of thirty-eight patients diagnosed with senile cataract and primary open angle glaucoma were divided into two equal groups. Group A underwent Phaco-deep sclerectomy (PDS) with mitomycin C (MMC) while group B underwent phaco-trabeculectomy (PT). Postoperative IOP was followed up for six months. Results By the end of the sixth month complete success (IOP < 21mmHg without anti-glaucoma therapy) was achieved in 80% in group A and 84% in group B. By the end of the sixth month qualified or partial success (IOP < 21mmHg with anti-glaucoma therapy) was achieved in 12% in both groups A and B. Conclusion P-DS with MMC does not exceed conventional P-T in what concerns IOP reduction. However the complication rate is lower in P-DS. Augmentation of PDS with MMC is safe with few serious complications related to its use and MMC augmentation appears to increase the probability of achieving lower target intraocular pressures after combined P-DS.

KEYWORDS: Combined surgery-Deep sclerectomy-Mitomycin C-Phacoemulsification- Trabeculectomy

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