COMPARISON OF COMBINED CATARACT AND GLAUCOMA SURGERY USING PLANNED EXTRACAPSULAR AND PHACOEMULSIFICATION TECHNIQUES

BACKGROUND AND OBJECTIVE: The surgical management of coexisting catara ct and glaucoma is a common problem for the ophthalmologist. PATIENTS AND METHODS: We evaluated intraocular pressure (IOP) reduction and ble b formation in combined cataract and filtration surgery, comparing pla nned extracapsular cataract extraction (ECCE) and phacoemulsification approaches coupled with similar trabeculectomy techniques. Seventy-two eyes with primary open-angle or pseudoexfoliation glaucoma underwent combined cataract and filtration surgery. Thirty-five eyes underwent p lanned ECCE, intraocular lens (IOL) implantation, and trabeculectomy, and 37 eyes underwent phacoemulsification, IOL implantation and trabec ulectomy. Minimum follow-up for both groups was 1 year with a mean of 16 months. RESULTS: The mean IOP reduction for phacoemulsification/tra beculectomy eyes (5.0 +/- 4.3 mm Hg) was significantly lower than the mean IOP reduction for ECCE/trabeculectomy eyes (2.9 +/- 4.1 mm Hg; P < 0.03). There was no;significant difference between the groups in ter ms of visual acuity improvement or glaucoma medication reduction. CONC LUSION: Combined cataract and filtration surgery using phacoemulsifica tion is associated with greater IOP reduction than combined surgery us ing ECCE.