Intraocular pressure control after combined phacotrabeculectomy versus trabeculectomy alone

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Research

Background:

• Glaucoma management often requires surgical intervention to lower intraocular pressure (IOP).
• Trabeculectomy and phacotrabeculectomy are common surgical procedures for glaucoma.
• Comparing the efficacy and safety of these procedures is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the efficacy and safety of trabeculectomy versus phacotrabeculectomy in pseudophakic patients with glaucoma.
• To evaluate success rates based on different intraocular pressure (IOP) thresholds.
• To assess the need for bleb needling and postoperative medication.

Main Methods:

• Retrospective analysis of consecutive patients undergoing trabeculectomy or phacotrabeculectomy.
• Patients in the trabeculectomy group were pseudophakic.
• Success was measured using three IOP thresholds (<21, <18, <15 mmHg) for complete and qualified success, analyzed with Kaplan-Meier curves.

Main Results:

• Trabeculectomy showed significantly higher complete and qualified success rates, particularly with the strictest IOP criterion (C: <15 mmHg).
• The final mean IOP was significantly lower in the trabeculectomy group (10.95 mmHg) compared to the phacotrabeculectomy group (13.00 mmHg).
• Bleb needling was required more frequently in the phacotrabeculectomy group.

Conclusions:

• Trabeculectomy alone is more effective in pseudophakic eyes, achieving higher success rates and lower mean IOP.
• Phacotrabeculectomy may necessitate more frequent follow-up and prolonged use of topical steroids.
• These findings guide surgical choices for glaucoma patients, particularly those who are pseudophakic.