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Published on: January 26, 2018
Combined trabeculectomy and phacoemulsification: a one-site vs a two-site approach
T Wyse1, M Meyer, J M Ruderman
1Glaucoma Service, Department of Ophthalmology, Northwestern University Medical School, Chicago, Illinois 60611, USA.
American Journal of Ophthalmology
|March 25, 1998
Summary
This study compared one-site and two-site glaucoma surgeries. Both methods effectively reduced intraocular pressure and improved vision, but the two-site approach required fewer medications long-term.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Glaucoma Management
Background:
- Cataracts and glaucoma often coexist, necessitating combined surgical interventions.
- Combined trabeculectomy and phacoemulsification offer a solution for patients with both conditions.
- Surgical approach variations, such as one-site versus two-site, may impact outcomes.
Purpose of the Study:
- To compare the efficacy of one-site versus two-site combined trabeculectomy and phacoemulsification with intraocular lens implantation.
- To evaluate differences in intraocular pressure control and visual acuity outcomes between the two surgical approaches.
Main Methods:
- Randomized study of glaucoma patients with coexisting cataracts.
- One-site surgery: Limbus-based conjunctival flap and scleral tunnel at 12-o'clock.
- Two-site surgery: Superior nasal trabeculectomy and temporal clear cornea incision for phacoemulsification.
- Mitomycin C application and intraocular lens implantation were consistent across both groups.
Main Results:
- Both one-site and two-site approaches resulted in similar improvements in corrected visual acuity.
- Intraocular pressure reduction was comparable between the groups, with no statistically significant difference at last follow-up (P = .129).
- The one-site group required significantly more glaucoma medications postoperatively compared to the two-site group (P = .030).
Conclusions:
- Combined trabeculectomy and phacoemulsification surgery, regardless of one-site or two-site approach, provide similar visual acuity and intraocular pressure reduction.
- The two-site approach may offer an advantage in long-term intraocular pressure management, potentially reducing medication dependence.
- Further research may explore patient selection criteria for optimizing outcomes with each surgical technique.
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