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

Purpose: To compare 1-site and 2-site combined phacoemulsification with fol dable intraocular lens (IOL) implantation and trabeculectomy. Setting: El-Maghraby Eye Hospital, Jeddah, Saudi Arabia. Methods: Seventy-six eyes with coexisting cataract and glaucoma were random ly assigned to have a mitomycin-C trabeculectomy in a superior quadrant com bined with phacoemulsification and foldable IOL implantation through the sa me incision (1-site group) or a separate, temporal, clear corneal incision (2-site group). Postoperative evaluation included visual acuity, intraocula r pressure (IOP), bleb assessment, and number of antiglaucoma medications. Follow-up ranged from 12 to 18 months. Results: Mean preoperative IOP was 28.1 mm Hg +/- 7.1 (SD) in the 2-site gr oup and 26.2 +/- 6.5 mmHg in the 1-site group. At 6 months postoperatively, mean IOP was 16.9 +/- 4.3 and 16.8 +/- 3.8 mm Hg, respectively (P = .9) an d at 12 months, 17.6 +/- 3.3 and 19.1 +/- 3.1 mm Hg, respectively (P = .044 ). Twenty-three of 39 eyes (59%) in the 2-site group and 14 of 37 (38%) in the 1-site group had clinically apparent filtering blebs at 12 months (P = .065). Postoperative astigmatic change and complications were comparable. Conclusion: Mitomycin-C trabeculectomy superiorly combined with separate te mporal clear corneal phacoemulsification provided 1 year IOP control compar able to that with single-incision (1-site) combined cataract and glaucoma s urgery.