LIMBAL-BASED VS FORNIX-BASED CONJUNCTIVAL FLAPS IN COMBINED EXTRACAPSULAR CATARACT-SURGERY AND GLAUCOMA FILTERING PROCEDURE

Extracapsular cataract extractions and posterior chamber intraocular lens implantations combined with glaucoma filtering procedures were done in 47 eyes of 43 consecutive patients who had coexisting cataract and glaucoma. A limbal-based conjunctival flap was used in 22 patients and a fornix-based flap was used in 25 patients; the surgical technique was otherwise identical in all patients. Patients were followed up for a minimum of six months (mean, 18 months). Long-term intraocular pressure control and visual acuity were similar in the two groups, although the limbal-based group had significantly better early postoperative intraocular pressure control. Because control of intraocular pressure during the early postoperative period is a principal benefit of combined cataract and glaucoma surgery, we prefer the limbal-based conjunctival flap.