Phacotrabeculectomy versus two-stage operation: A matched study

BACKGROUND AND OBJECTIVE: To evaluate the efficacy and safety of phacoemuls ification and foldable intraocular lens, combined with trabeculectomy (phac otrabeculectomy) in patients with coexisting cataract and glaucoma. PATIENTS AND METHODS: A total of 53 consecutive eyes which underwent phacot rabeculectomy and posterior chamber intraocular lens (PCIOL) were matched a nd compared with 53 eyes that had trabeculectomy followed by phacoemulsific ation and posterior chamber intraocular lens (mean interval 3.2 month). The 2 groups were first matched by diagnostic group and subsequently for the c losest possible match with other successive variables, including age, gende r, race and preoperative glaucoma medications. Mean intraocular pressure (I OP) reduction, visual acuity, antiglaucoma medications, and surgical succes s as well as complications were compared in both groups. RESULTS: Mean IOP reduction was 14.5+/-4.1 mmHg in the two-stage group comp ared to 15.1+/-3.9 in the phacotrabeculectomy group at 6 months follow-up ( P<0.1) and 13.8+/-3.9 and 14.6+/-3.7 respectively at 1 year (P<0.1).Visual acuity and complications were comparable. CONCLUSION: Phacotrabeculectomy provides IOP control statistically comparab le to two-stage surgery with earlier visual rehabilitation.