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Temporal corneal phacoemulsification combined with superior trabeculectomy. A retrospective case-control study
H J Park1, M Weitzman, J Caprioli
1Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Conn, USA.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|March 1, 1997
Summary
Combined cataract and glaucoma surgery showed less long-term intraocular pressure (IOP) reduction than trabeculectomy alone. However, combined surgery effectively lowers IOP and reduces medication needs in selected patients.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Cataract Surgery
Background:
- Cataract and glaucoma often coexist, requiring surgical intervention.
- Evaluating combined surgical approaches is crucial for managing these conditions effectively.
Purpose of the Study:
- To compare the efficacy of combined temporal corneal phacoemulsification and superior trabeculectomy with trabeculectomy alone for intraocular pressure (IOP) control.
- To assess the impact on visual acuity and medication requirements.
Main Methods:
- Retrospective case-control study of 80 patients (40 combined surgery, 40 trabeculectomy alone).
- Both groups received low-dose 5-fluorouracil injections.
- Follow-up for at least 1 year, with survival analyses for IOP control.
Main Results:
- Combined surgery group had statistically higher postoperative IOP at all intervals (P < .05).
- One-year IOP reduction was less in the combined group (6.8 mm Hg) versus trabeculectomy alone (10.3 mm Hg) (P = .04).
- Combined surgery improved visual acuity and showed a trend towards reduced medication needs (P = .06).
Conclusions:
- Combined cataract and glaucoma surgery results in less long-term IOP reduction compared to trabeculectomy alone.
- Despite this, combined surgery is effective in lowering IOP and decreasing medication dependence.
- This approach is suitable for carefully selected patients with coexisting cataract and glaucoma.