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Related Experiment Videos

Combined cataract extraction and trabeculectomy: phacoemulsification compared with extracapsular technique

P K Wishart1, M W Austin

  • 1St Paul's Eye Unit, Royal Liverpool University Hospital, United Kingdom.

Ophthalmic Surgery
|December 1, 1993
PubMed
Summary

Phacoemulsification with trabeculectomy (PHACO + TRAB) offers better visual recovery and long-term intraocular pressure control than extracapsular cataract extraction with trabeculectomy (ECCE + TRAB). This advanced technique reduces complications and astigmatism.

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Glaucoma Management

Background:

  • Cataract and glaucoma often coexist, requiring combined surgical approaches.
  • Extracapsular cataract extraction with trabeculectomy (ECCE + TRAB) has been a standard procedure.
  • Phacoemulsification with trabeculectomy (PHACO + TRAB) represents a newer technique with potential advantages.

Purpose of the Study:

  • To compare the postoperative outcomes of PHACO + TRAB versus ECCE + TRAB.
  • To evaluate visual rehabilitation, refractive stability, and complication rates.
  • To assess long-term intraocular pressure control in combined glaucoma and cataract surgery.

Main Methods:

  • Prospective study of 34 eyes undergoing PHACO + TRAB.
  • Retrospective comparison with 34 eyes that underwent ECCE + TRAB.

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  • All eyes received posterior chamber intraocular lens implants and were followed for 1 year.

    • Main Results:

    • PHACO + TRAB group showed earlier visual rehabilitation and significantly less postoperative astigmatism (P < .001).
    • Improved long-term intraocular pressure control was observed in the PHACO + TRAB group (P = .04).
    • PHACO + TRAB had fewer complications, including hyphema, fibrinous iritis, choroidal detachment, hypotony, and posterior capsular opacification.

    Conclusions:

    • PHACO + TRAB is superior to ECCE + TRAB for combined cataract and glaucoma surgery.
    • The small incision in phacoemulsification contributes to better wound stability, reduced astigmatism, and improved IOP control.
    • PHACO + TRAB facilitates faster visual recovery and lowers the incidence of significant postoperative complications.