Comparative study of phacoemulsification-subscleral trabeculectomy versus phacoemulsification-deep sclerectomy

To compare the surgical outcomes of phacoemulsification-subscleral trabeculectomy versus phacoemulsification-deep sclerectomy with intraoperative mitomycin C in open-angle glaucoma.

The study was conducted on 40 chronic primary open-angle glaucomatous eyes with senile cataract. They were divided into two groups: group I (n = 20): eyes undergoing phacoemulsification with subscleral trabeculectomy, and group II (n = 20): eyes undergoing phacoemulsification with deep sclerectomy. Intraoperative mitomycin C (0.4 mg/ml for 3 min) was applied in both groups. Postoperative intraocular pressure (IOP), complications, glaucoma medications, visual outcomes, and the bleb appearance were assessed for 12 months.

The mean postoperative IOP was significantly lower (P < 0.05) in both groups in all time intervals in comparison to their preoperative values. The mean postoperative IOP was 14.1 ± 5.4 mmHg in group I, and 14.8 ± 3.1 mmHg in group II. No major complications were encountered in either procedure, but complications such as shallow anterior chamber, hypotony, and delayed bleb leaks were common in group I, whereas intraoperative perforation of Descemet's membrane occurred in group II. No significant difference in visual acuity improvement, visual field changes, and surgical success outcome were found between both groups.

There was no significant difference in IOP reduction, surgical complications and visual outcomes between subscleral trabeculectomy, or deep sclerectomy with intraoperative mitomycin C in combination with phacoemulsification and intraocular lens implantations in patients with primary open-angle glaucoma.