Combined surgery in the treatment of patients with cataract and primary open-angle glaucoma

The literature on combined surgery in the treatment of patients with catara ct and primary open-angle glaucoma was comprehensively studied, and all asp ects and variations of the combined procedure were assessed. Phacoemulsific ation has improved the success rate and reduced the complication rate previ ously associated with extracapsular cataract extraction combined with trabe culectomy. A mean reduction in intraocular pressure (IOP) of 5 to 8 mm Hg c an be achieved. One- and 2-site techniques appear to be similarly effective . Phacotrabeculectomy augmented with mitomycin-C achieves a lower IOP than phacotrabeculectomy alone but has a higher complication rate. The use of 5- fluorouracil is not as effective as mitomycin-C and has a variable influenc e on the results. The development of new techniques that combine nonpenetra ting glaucoma surgery with phacoemulsification offers interesting surgical alternatives, but no longterm results have been reported. (C) 2001 ASCRS an d ESCRS.