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Related Experiment Videos

One-site versus 2-site phacotrabeculectomy: a randomized study

F el Sayyad1, M Helal, A el-Maghraby

  • 1El-Maghraby Eye Hospital, Jeddah, Saudi Arabia.

Journal of Cataract and Refractive Surgery
|January 15, 1999
PubMed
Summary
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This study compared single-incision versus two-incision combined cataract and glaucoma surgery. Both approaches achieved comparable intraocular pressure control after one year, with similar complication rates.

Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Glaucoma Management

Background:

  • Cataract and glaucoma often coexist, necessitating combined surgical approaches.
  • Current surgical techniques aim to optimize intraocular pressure (IOP) control and visual outcomes.
  • Phacoemulsification with foldable intraocular lens (IOL) implantation and trabeculectomy are standard procedures.

Purpose of the Study:

  • To compare the efficacy and safety of a 1-site versus a 2-site surgical approach for combined phacoemulsification with foldable IOL implantation and mitomycin-C trabeculectomy.
  • To evaluate intraocular pressure (IOP) control, visual acuity, and complication rates between the two surgical techniques.

Main Methods:

  • A randomized study involving 76 eyes with coexisting cataract and glaucoma.

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  • Eyes were assigned to either a 1-site group (combined surgery through a single incision) or a 2-site group (separate incisions for trabeculectomy and phacoemulsification/IOL).
  • Postoperative assessments included visual acuity, IOP, bleb assessment, and medication use, with follow-up ranging from 12 to 18 months.

    • Main Results:

    • Mean preoperative IOP was similar between the 2-site (28.1 mm Hg) and 1-site (26.2 mm Hg) groups.
    • Postoperative IOP at 12 months was comparable: 17.6 mm Hg (2-site) vs. 19.1 mm Hg (1-site) (P = .044).
    • Filtering bleb presence at 12 months was 59% in the 2-site group versus 38% in the 1-site group (P = .065). Postoperative astigmatism and complications were similar.

    Conclusions:

    • Combined mitomycin-C trabeculectomy and phacoemulsification/IOL implantation using a 1-site or 2-site approach provides comparable IOP control at one year.
    • The choice between 1-site and 2-site surgery may depend on specific clinical factors and surgeon preference, as outcomes are similar.