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Comparative study of phacoemulsification-subscleral trabeculectomy versus phacoemulsification-deep sclerectomy
Tahrwat H Mokbel1, Asaad A Ghanem, Ashraf I Moawad
1Ophthalmology Center, Faculty of Medicine, Mansoura University, Egypt.
Summary
Phacoemulsification combined with either subscleral trabeculectomy or deep sclerectomy showed similar outcomes for open-angle glaucoma patients. Both procedures effectively lowered intraocular pressure with comparable visual results and complication rates.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Cataract Surgery
Background:
- Open-angle glaucoma and cataracts often coexist, requiring combined surgical approaches.
- Phacoemulsification with intraocular lens implantation is standard for cataracts.
- Glaucoma surgery aims to reduce intraocular pressure (IOP) to prevent optic nerve damage.
Purpose of the Study:
- To compare surgical outcomes of phacoemulsification-subscleral trabeculectomy versus phacoemulsification-deep sclerectomy.
- Both procedures were combined with intraoperative mitomycin C for open-angle glaucoma patients.
Main Methods:
- Forty eyes with chronic primary open-angle glaucoma and cataracts were studied.
- Group I (n=20) underwent phacoemulsification with subscleral trabeculectomy.
- Group II (n=20) underwent phacoemulsification with deep sclerectomy, both with mitomycin C.
Main Results:
- Both groups showed significant IOP reduction post-surgery.
- Mean IOP was 14.1±5.4 mmHg (Group I) and 14.8±3.1 mmHg (Group II).
- No major complications, though some minor issues like shallow anterior chamber and hypotony occurred in Group I, and Descemet's membrane perforation in Group II.
Conclusions:
- No significant difference in IOP reduction between the two surgical techniques.
- Surgical complications and visual outcomes were comparable for both subscleral trabeculectomy and deep sclerectomy.
- Combined phacoemulsification and either glaucoma procedure offer similar efficacy for open-angle glaucoma.