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Results of combined phacoemulsification and trabeculectomy in patients with elevated preoperative intraocular
W C Stewart1, C M Crinkley, A N Carlson
1Glaucoma Service at the Department of Ophthalmology at the Medical University of South Carolina, Charleston, South Carolina, U.S.A.
Purpose:
We evaluated the results of 17 consecutive patients with high intraocular pressures and visually significant cataracts who underwent combined phacoemulsification and trabeculectomy.
Methods:
We individually matched each patient by age, race, and intraocular pressure (trabeculectomy group only) to two control groups: group 1, patients who had combined phacoemulsification and trabeculectomy and whose intraocular pressures were controlled preoperatively (pressure =18 mm Hg), and group 2, patients who had high intraocular pressures preoperatively and trabeculectomy alone. Only patients with chronic open-angle glaucoma undergoing initial filtration surgery were included.
Results:
One year postsurgery there was no statistically significant difference between study patients and either control group in terms of intraocular pressure (p > 0.05). Moreover, no statistical difference was observed between groups at 1 year postsurgery in number of glaucoma medications, bleb height or extent, anterior chamber depth, or bleb vascularity (p > 0.05). Additionally, both study and control patients had a statistically similar peak pressure the first month following surgery (p > 0.05). Complications were similar among groups.
Conclusion:
This study suggests that patients with chronic open-angle glaucoma and high intraocular pressure may undergo combined trabeculectomy and phacoemulsification and achieve long-term postoperative intraocular control similar to those patients who have trabeculectomy only or a combined procedure and controlled preoperative pressure.
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