Small incision trabeculotomy combined with phacoemulsification and intraocular lens implantation.

Cataract surgeons frequently face the challenge of treating an open-angle glaucoma patient presenting for cataract surgery and intraocular lens implantation. It seems logical to treat both problems during the same surgical procedure if it can be done without jeopardizing the results of either. We present a short historic overview of the trabeculotomy procedure in adults, together with our technique using the new Fukasaku modification of the instrumentation (probes and forceps) and report 50 consecutive cases with a 100% three-month follow-up. The mean preoperative intraocular pressure was 19.3 mm Hg (range 16.0 to 37.0 mm Hg); three months after surgery it was 14.2 mm Hg (range 6.0 to 24.0 mm Hg). The mean preoperative pressure-reducing medications were 2.3 drugs per patient, and the postoperative mean was 0.7. Except for three cases of small postoperative hyphemas, no other complications were encountered during the study.