Manual small incision cataract surgery combined with trabeculectomy versus phacoemulsification combined with trabeculectomy for coexisting glaucoma and cataract: a systematic review and meta-analysis

Amaral, Dillan Cunha; Guedes, Jaime; de Oliveira Caneca, Karina; Pereira, Sacha F.; Alves, Milton Ruiz; Manso, José Eduardo Ferreira; Ribeiro Monteiro, Mário Luiz; Louzada, Ricardo Noguera

doi:10.1080/17469899.2024.2346506

Cited by 3 publications

(1 citation statement)

References 45 publications

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“…Alternatively, optical biometry employs optical partial coherence interferometry (PCI) to determine the axial length in vivo, quantifying the distance from the cornea’s anterior surface to the retinal pigment epithelium [ 30 ]. Understanding the pars plana is crucial for various procedures, including cyclophotocoagulation and trabeculectomy, to ensure effective and safe treatment outcomes [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

A Morphometric Study of the Pars Plana of the Ciliary Body in Human Cadaver Eyes

Guedes,

Fernandes,

Mora-Paez

et al. 2024

Vision

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This study aimed to determine the pars plana length in postmortem human eyes using advanced morphometric techniques and correlate demographics to ocular metrics such as age, sex, ethnicity, and axial length. Between February and July 2005, we conducted a cross-sectional observational study on 46 human cadaver eyes deemed unsuitable for transplant by the SBO Eye Bank. The morphometric analysis was performed on projected images using a surgical microscope and a video-microscopy system with a 20.5:1 correction factor. The pars plana length was measured three times per quadrant, with the final value being the mean of these measurements. Of the 46 eyes collected, 9 were unsuitable for the study due to technical constraints in conducting intraocular measurements. Overall, the average axial length was 25.20 mm. The average pars plana length was 3.8 mm in all quadrants, with no measurements below 2.8 mm or above 4.9 mm. There were no statistically significant variations across quadrants or with age, sex, axial length, or laterality. Accurately defining the pars plana dimensions is crucial for safely accessing the posterior segment of the eye and minimizing complications during intraocular procedures, such as intravitreal injections and vitreoretinal surgeries.

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Section: Discussionmentioning

confidence: 99%

A Morphometric Study of the Pars Plana of the Ciliary Body in Human Cadaver Eyes

Guedes,

Fernandes,

Mora-Paez

et al. 2024

Vision

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Cataract surgery combined with glaucoma surgery

Torbey,

Mansouri

2024

Current Opinion in Ophthalmology

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Purpose of review This review evaluates the surgical management of glaucoma in patients undergoing cataract surgery. Combining both procedures present challenges in balancing intraocular pressure (IOP) control, minimizing postoperative complications, and achieving optimal refractive outcomes. Recent findings Recent studies highlight the effectiveness of combined glaucoma and cataract surgeries, with traditional filtering surgeries and MIGS showing significant IOP reduction. The abundance of long-term studies shows that MIGS can offer an effective and safer alternative when carefully tailored to meet the specific needs of each patient. Summary Combining glaucoma and cataract surgery is a promising approach for patients with coexisting conditions. While traditional surgeries offer robust IOP reduction, MIGS procedures offer better safety profiles with fewer complications and more predictable refractive results. Surgeons must carefully consider the timing and choice of procedures, with further research required to develop standardized treatment algorithms.

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Phaco-Chop versus Divide-and-Conquer in Patients Who Underwent Cataract Surgery: A Systematic Review and Meta-Analysis

Guedes,

Pereira,

Amaral

et al. 2024

OPTH

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Background: Cataract surgery is one of the most frequently performed eye surgeries worldwide, and among several techniques, phacoemulsification has become the standard of care due to its safety and efficiency. We evaluated the advantages and disadvantages of two phacoemulsification techniques: phaco-chop and divide-and-conquer. Methods: PubMed, Cochrane, Embase, and Web of Science databases were queried for randomized controlled trial (RCT), prospective and retrospective studies that compared the phaco-chop technique over the divide-and-conquer technique and reported the outcomes of (1) Endothelial cell count change (ECC); (2) Ultrasound time (UST); (3) Cumulated dissipated energy (CDE); (4) Surgery time; and (5) Phacoemulsification time (PT). Heterogeneity was examined with I 2 statistics. A random-effects model was used for outcomes with high heterogeneity. Results: Nine final studies, (6 prospective RCTs and 3 observational), comprising 837 patients undergoing phacoemulsification. 435 (51.9%) underwent the phaco-chop technique, and 405 (48.1%) underwent divide-and-conquer. Overall, the phaco-chop technique was associated with several advantages: a significant difference in ECC change postoperatively (Mean Difference [MD] −221.67 Cell/mm 2 ; 95% Confidence Interval [CI] −401.68 to −41.66; p < 0.02; I2=73%); a shorter UST (MD −51.16 sec; 95% CI −99.4 to −2.79; p = 0.04; I2=98%); reduced CDE (MD −8.68 units; 95% CI −12.76 to −4.60; p < 0.01; I2=84%); a lower PT (MD −55.09 sec; 95% CI −99.29 to −12.90; p = 0.01; I2=100). There were no significant differences in surgery time (MD −3.86 min; 95% CI −9.55 to 1.83; p = 0.18; I2=99%). Conclusion:The phaco-chop technique proved to cause fewer hazards to the corneal endothelium, with less delivered intraocular ultrasound energy when compared to the divide-and-conquer technique.

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Manual small incision cataract surgery combined with trabeculectomy versus phacoemulsification combined with trabeculectomy for coexisting glaucoma and cataract: a systematic review and meta-analysis

Cited by 3 publications

References 45 publications

A Morphometric Study of the Pars Plana of the Ciliary Body in Human Cadaver Eyes

A Morphometric Study of the Pars Plana of the Ciliary Body in Human Cadaver Eyes

Cataract surgery combined with glaucoma surgery

Phaco-Chop versus Divide-and-Conquer in Patients Who Underwent Cataract Surgery: A Systematic Review and Meta-Analysis

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