[Combined cataract and glaucoma surgery. Trabeculectomy vs Erb:YAG goniotomy]

The surgical therapy of glaucoma aims at an effective IOP lowering as well as at a long-term effect with few complications. The previous gold standard of combined surgery consisted of cataract surgery and trabeculectomy. The combination of cataract surgery and Erb:YAG goniotomy might be an alternative.

A total of 17 eyes were treated with combined Erb:YAG goniotomy. The control group underwent combined trabeculectomy and consisted of 23 eyes. The mean follow-up was 5 years and assessed IOP lowering, visual acuity, antiglaucomatous drugs, and complications.

After 5 years the IOP of the Erb:YAG group decreased from 23.3 to 16.9 mmHg. In the control group, the IOP was reduced from 23.3 mmHg to 15.8 mmHg. Two eyes of the Erb:YAG group needed further surgery due to insufficient IOP control, whereas in the control group ten repeat procedures were necessary.

The small number of complications in combination with a sustainable IOP-lowering effect seems to be an advantage in the long-term treatment of glaucoma. We hope that this can be transferred to the new excimer laser trabeculotomy since the 3-year results are already comparable to the Erb:YAG laser.