First Author: S.Synek CZECH REPUBLIC
Co Author(s):
Purpose:
To compare phacoemulsification alone versus combined phacotrabeculectomy in medically controlled chronic angle closure glaucoma (CACG) with coexisting cataract.
Setting:
Department of Ophthalmology and Optometry, St. Anne Hospital, Medical Faculty, Masaryk University, Brno, Czech Republic
Methods:
Seventy-two medically controlled CACG eyes with coexisting cataract were randomized into group 1 (phacoemulsification alone) or group 2 (combined phacotrabeculectomy). Postoperatively, patients were reviewed every 3 months for 2 years.
Results:
Thirty-five CACG eyes were randomized into group 1, and 37 CACG eyes were randomized into group 2. There were no statistically significant differences (P>0.05) in mean IOP between the 2 treatment groups preoperatively and postoperatively, except at 1 month (P = 0.001) and 3 months (P = 0.008). Combined phacotrabeculectomy resulted in 0.80 less topical glaucoma drugs (P<0.001) in the 24-month postoperative period compared with phacoemulsification alone. The differences in IOP control were, however, not associated with differences in glaucomatous progression. Combined surgery was associated with more postoperative (P<0.001) complications compared with phacoemulsification alone.
Conclusions:
Combined phacotrabeculectomy may be marginally more effective than phacoemulsification alone in controlling IOP in medically controlled CACG eyes with coexisting cataract. Combined surgery may be associated with more complications and additional surgery in the postoperative period. Further study is needed to determine whether the marginally better IOP control of combined surgery justifies the potential additional risks of complications and further surgery. FINANCIAL DISCLOSURE?: No
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