Combined phacoemulsification and trabeculectomy versus trabeculectomy alone: a comparison study using mitomycin-C

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Outcomes

Background:

• Glaucoma is a leading cause of irreversible blindness worldwide.
• Trabeculectomy is a common surgical procedure to lower intraocular pressure (IOP).
• Combined procedures may offer advantages in specific patient populations.

Purpose of the Study:

• To compare the efficacy and safety of combined phacoemulsification and trabeculectomy (PEM/TRAB) plus mitomycin-C versus trabeculectomy alone (TRAB) plus mitomycin-C.
• To evaluate intraocular pressure reduction and medication requirements post-surgery.
• To assess complication rates and bleb survival between the two surgical techniques.

Main Methods:

• Retrospective review of 42 eyes undergoing combined PEM/TRAB with mitomycin-C.
• An age-matched control group of 42 eyes undergoing TRAB with mitomycin-C was selected.
• All patients had a minimum follow-up of 12 months.

Main Results:

• Postoperative intraocular pressure (IOP) was significantly lower in both groups at all follow-up intervals.
• At final follow-up (mean 21.8 months), mean IOP was 13.9 mmHg for PEM/TRAB and 12.3 mmHg for TRAB.
• Both groups required significantly fewer glaucoma medications post-surgery, with similar complication rates and excellent bleb survival.

Conclusions:

• Combined PEM/TRAB with mitomycin-C demonstrates comparable success rates to TRAB alone for glaucoma management.
• The combined approach effectively reduces IOP and medication dependence.
• Both surgical techniques are associated with similar safety profiles.