Combined surgery of cataract and glaucoma with drainage «Repegel A-1» implantation

Purpose. To evaluate the hypotensive and visual functions effect caused by combined сataract and filtering glaucoma surgery. Material and methods. The study was done on 34 patients with glaucoma and cataract who were operated, of which 2 (5.9%) had the initial stage of glaucoma, 5 (14.7%) of them – at the developed stage and 27 (79.4%) – at the severe stage. The tonometric pressure was 27.6±1.8 mm Hg; uncorrected visual acuity – 0.17±0.21; best corrected visual acuity – 0.31±0.24. According to the LOCS III classification, 3 (8.8%) had soft lens density nuclear cataract (NC) 1–3, 23 (67.4%) had NC 4–5, and 8 (23.5%) had NC 6. At 11 o’clock 4 mm from the limbus, scleral tunnel 2.2 mm wide is formed through the conjunctiva in the anteriorposterior direction, in the surface layers of the sclera with the exit of the knife through the angle into the anterior chamber, 2 paracentesis are made. Circular capsulorhexis and phacoaspiration of the lens are performed. The scleral tunnel is expanded to 3 mm, and an intraocular lens is implanted. With tweezers – through paracentesis, and scissors – through the scleral tunnel, a pericorneal coloboma of the iris is formed. A T-shaped form of drainage «Repegel A-1» is formed. The drain is implanted into the intrascleral tunnel. Results. The proposed surgery method allows to reduce intraocular pressure from 27.6 to 19.1 mm Hg, as well as to improve best corrected visual acuity from 0.31 to 0.5. Conclusion. Combined surgery allows to perform phacoemulsification, intraocular lens implantation and glaucoma drainage surgery through the one scleral incision, which leads to a decrease in intraocular pressure to 19.1 mm Hg and an improvement in best corrected visual acuity to 0.5. Key words: glaucoma, cataract, phacoemulsification, intraocular pressure