Combined cyclectomy-trabeculectomy procedure for refractory glaucoma.

A new surgical technique for cases of refractory glaucoma is described. The technique has been performed on 42 severely glaucomatous eyes. The technique consists of a partial excision of the ciliary body combined with a trabeculectomy to maintain an effective filtration by several passages. All excised material was verified as ciliary body by an ophthalmic pathologist. The follow-up period was 2 to 5 years. Intraocular pressure decreased after the operation and remained less than 20 mm Hg in 39 eyes. The visual acuity increased in 8 of 42 eyes and remained the same in 32 eyes. Complications were similar to those seen after trabeculectomy. This method is efficient for severely glaucomatous eyes that are difficult to manage with trabeculectomy alone.