No need for antimetabolites?

Combined phacoemulsification and trabeculectomy with releasable sutures can be performed safely and effectively in the absence of antimetabolites, according to a study published in the February 2006 issue of the British Journal of Ophthalmology.

The analysis of 251 eyes of 198 patients after a combined phaco/trabeculectomy procedure was carried out by Walter J. Stark, MD and colleagues of Wilmer Eye Institute, John Hopkins University, Baltimore, USA.Patients were followed up for, on average, 16 months and were evaluated for vision, intraocular pressure (IOP) and a series of glaucoma medications.

The investigators noted a mean postoperative decrease of 19.2% for IOP and 84.1% for a number of glaucoma medications; 85% of eyes required fewer glaucoma medications and 78% of eyes were medication free, with IOP control.

The authors concluded that the procedure is a safe, effective and stable alternative for patients with cataracts and glaucoma in the absence of antimetabolites.