Cataract versus combined surgery in pseudoexfoliation glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Outcomes

Background:

• Pseudoexfoliation glaucoma (XFG) presents unique challenges, often linked to increased intraoperative complications and surgical failure.
• Understanding the long-term efficacy of different surgical approaches in XFG is crucial for patient management.

Purpose of the Study:

• To compare the long-term clinical and surgical outcomes of isolated cataract surgery versus combined cataract and glaucoma surgery in patients with XFG.

Main Methods:

• A retrospective comparative case series included 81 eyes of 68 patients with XFG, divided into two groups: cataract surgery alone (n=35) and combined surgery (n=46).
• Patients were followed for a minimum of 3 years with detailed clinical examinations and Humphrey visual field analysis.
• Key outcome measures included intraocular pressure (IOP) reduction, surgical success rates, survival rates, visual field changes, and need for additional interventions.

Main Results:

• Both groups demonstrated significant IOP reduction (27-40%) from baseline (P < 0.001).
• Surgical success rates were comparable: complete success (66% vs. 55%, P=0.4) and qualified success (17% vs. 24%, P=0.8) between isolated cataract surgery and combined surgery, respectively.
• Long-term follow-up showed similar rates of visual field progression and comparable survival rates between the two surgical approaches.

Conclusions:

• Isolated cataract surgery can achieve comparable long-term efficacy to combined surgery in eyes with pseudoexfoliation glaucoma.
• Final visual acuity, long-term IOP management, and visual field progression are similar between the two procedures.
• Complication and survival rates are comparable, suggesting cataract surgery alone is a viable option for XFG patients.