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Updated: Jun 11, 2025
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Long-term Outcomes of Combined Phacotrabeculectomy Surgery in a Singapore Tertiary Hospital
Annabel Cy Chew1, Hla Myint Htoon2, Shamira A Perera1
1Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore; Duke-NUS Graduate Medical School, Singapore.
Purpose:
To describe the long-term outcomes of phacotrabeculectomy from a tertiary glaucoma service in Singapore.
Design:
Retrospective case series.
Methods:
Seven hundred ninety-six eyes of 698 patients who underwent phacotrabeculectomy surgery at the Singapore National Eye Centre between 2005 and 2007 with a minimum follow-up of three years were included. The primary outcome measure was intraocular pressure (IOP). Secondary outcomes included best-corrected visual acuity (BCVA), number of glaucoma medications, and surgical complications.
Results:
The mean age was 69.5 years, 51 % were male, and 86 % were Chinese. Most eyes had primary glaucoma (90.6 %). The mean follow-up duration was 9.4 years. The overall success rate at three years was 97 % if surgical success was defined as IOP ≤ 21 mm Hg, 92 % if IOP ≤ 18 mm Hg, 66 % if IOP ≤ 15 mm Hg. By Kaplan-Meier survival analysis over 13 years, the cumulative success rate fell from 98.1 % to 89.1 % if IOP ≤ 21 mm Hg, 98.1-76.9 % if IOP ≤ 18 mm Hg, 98-50.3 % if IOP ≤ 15 mm Hg. The postoperative IOP improved significantly at all time points (P < 0.05) and 72 % had at least 20 % IOP reduction. There was a slight improvement in postoperative BCVA (P < 0.05). The mean number of glaucoma medications was reduced postoperatively (P < 0.001). There were no significant risk factors for surgical failure.
Conclusions:
Phacotrabeculectomy was found to be safe, resulting in clinically significant IOP lowering for 13 years with reduced dependency on glaucoma medications and improved BCVA.
