Is combined phacoemulsification and trabeculectomy as effective as trabeculectomy alone?

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Intraocular Pressure Management

Background:

• Open-angle glaucoma requires effective intraocular pressure (IOP) reduction.
• Trabeculectomy (T) and phaco-trabeculectomy (PT) are surgical options for glaucoma management.
• Comparing the efficacy of these procedures is crucial for patient outcomes.

Purpose of the Study:

• To compare the IOP-lowering effect of trabeculectomy (T) versus single-site combined phaco-trabeculectomy (PT).
• To evaluate the long-term pressure reduction efficacy of both surgical techniques.

Main Methods:

• Retrospective chart review of 60 consecutive open-angle glaucoma patients.
• Patients underwent either trabeculectomy (T) or phaco-trabeculectomy (PT).
• Intraocular pressure was measured and compared at 12 months postoperatively.

Main Results:

• Both T and PT significantly lowered IOP after 12 months (p < 0.001).
• Trabeculectomy (T) resulted in a greater mean IOP reduction (11.44 mmHg) compared to phaco-trabeculectomy (PT) (5.00 mmHg).
• Postoperative IOP was significantly lower in the T-group (11.08 mmHg) than in the PT-group (15.04 mmHg) at 12 months (p < 0.001).

Conclusions:

• Trabeculectomy alone is more effective in lowering intraocular pressure than a combined phaco-trabeculectomy procedure.
• While combined phaco-trabeculectomy is effective, it achieves less significant IOP reduction compared to trabeculectomy alone.
• These findings suggest trabeculectomy as a potentially superior option for maximal IOP lowering in open-angle glaucoma.