The incidence of iris capture in combined cataract extraction and trabeculectomy

Purpose. To report the incidence of iris capture of the intraocular lens in combined cataract extraction/ glaucoma surgery as well as to determine possible predisposing variables to diis complication. Methods. Medical records of 108 patients who underwent combined surgery from 1986-1996 at our institution were analyzed in a retrospective fashion. Studied variables included preoperative factors; age, sex, operated eye. preoperative vision, pressure and visual field, type of glaucoma and preoperative medical therapy; intraoperative factors: method of cataract extraction, capsular opening, concomitant anterior vitrectomy, iris manipulation (manual stretch, sphincterotomies, use of hooks, sector indectomy), filter type and use of antimetabolite. postoperative factors; clock hours of capture, pressure, glare and astigmatism Results There was a ten percent incidence of ins capture of the intraocular lens in our series. Of patients without capture, 65% had capsulotomy, of patients with capture, 100% had capsulotomy Of patients without capture, 64% had iris manipulation, of patients with capture, 67% had intraoperative iris manipulation. Of patients without iris capture, 67% were treated preopcratively with miotics versus 46% of patients with ins capture. Of patients without iris capture, 57% had use of antimetabolite versus 58% of patients with iris capture. Of patients without iris capture 55% had phacoemulsification and 45% via extracapsular technique versus patients with ins capture. 15% had phacoemulsification and 85% had extracapsular cataract extraction. Conclusions. Incidence of iris capture in combined surgery in our retrospective analysis was 10%. Possible predisposing factors include capsulotomy and extraction via extracapsular technique Intraoperativc ins manipulation did not appear to predispose to ins capture of the intraocular lens.