Phacotrabeculectomy versus two-stage operation: a matched study

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma and Cataract Research

Background:

• Cataract and glaucoma frequently coexist, necessitating combined surgical approaches.
• Traditional management involves staged procedures, potentially delaying visual recovery.
• Phacotrabeculectomy offers a single-stage alternative for managing both conditions simultaneously.

Purpose of the Study:

• To evaluate the efficacy and safety of phacotrabeculectomy.
• To compare phacotrabeculectomy with a two-stage approach (trabeculectomy followed by phacoemulsification).
• To assess outcomes including intraocular pressure reduction and visual acuity.

Main Methods:

• A retrospective matched comparison of 53 eyes undergoing phacotrabeculectomy with 53 eyes undergoing staged surgery.
• Patients were matched for diagnosis, age, gender, race, and preoperative glaucoma medications.
• Key outcome measures included intraocular pressure (IOP) reduction, visual acuity, medication use, and complications.

Main Results:

• Both phacotrabeculectomy and the two-stage approach achieved comparable mean IOP reduction at 6 months and 1 year follow-up (P<0.1).
• Visual acuity outcomes and complication rates were similar between the two surgical groups.
• Phacotrabeculectomy demonstrated a trend towards slightly greater IOP reduction.

Conclusions:

• Phacotrabeculectomy provides effective intraocular pressure control comparable to staged surgery.
• The single-stage combined procedure offers the advantage of earlier visual rehabilitation.
• Phacotrabeculectomy is a safe and effective option for patients with coexisting cataract and glaucoma.