Revisiting the question on the role of trabeculocleaning in surgical treatment of glaucoma with concomitant cataract and pseudoexfoliation syndrome

Trabeculocleaning (TC) in the cataract extraction process is the procedure of debris aspiration from the drainage angle, one of the components inducing hypotensive efect after phacosurgery. When being preceded with selective laser trabeculoplasty (SLT) at suprathreshold values which provides a pigment granules' splatter, the described procedure makes it possible to clean the anterior chamber angle (ACA) of the released trabecular debris including pseudo-exfoliation material and pigment granules. Purpose: to study the efciency of trabeculocleaning performed in course of femto-laser assisted cataract surgery (FLACS), with a preliminary suprathreshold SLT. Material and Methods. The study included 26 patients (32 eyes) with a complicated cataract and primary open angle glaucoma with concomitant pseudoexfoliation syndrome. All patients underwent a suprathreshold SLT preceding FLACS and hydrodynamic tra-beculocleaning, in course of which trabecular debris were removed with the help of aspiration-irrigation tips. Results. One month postoperatively mean IOP value decreased by 9.5 mm Hg from initial values (40.95 %), the outfow facility coefcient improved to 0.21±0.002 mm3 / mm Hg*min (t=14.3; p<0.001). In 24 cases (77 %) IOP was compensated without application of antihypertensive drugs, in 7 cases (22.4 %) it reduced under medication. Conclusion. Hydrodynamic trabeculocleaning in course of FLACS with preliminary suprathreshold SLT ensures ACA detersion from trabecular debris: pseudoexfoliation material and pigment granules, therefore aiding to preserve and activate natural pathways to the outfow of intraocular fuid.