[Clinical observation of the combination of phacoemulsification and trabeculectomy]

Abstract

Objective: To evaluate the therapeutic effects of combined phacoemulsification and trabeculectomy surgery with intraocular lens implantation and compare the results of two different approaches.

Methods: In a retrospective study, forty eyes of 35 cases cataract patients with primary open-angle or chronic angle-closure glaucoma were assigned to undergo either a single incision (single incision group, 15 eyes) or two-incision (double incision group, 25 eyes). best-corrected visual acuity (BCVA), pre-and post-operation intraocular pressure (IOP), postoperative bleb formation and postoperative complications were analyzed and compared between the two procedures. All cases were followed up for over 12 months.

Results: The mean IOP of 35 cases (40 eyes) in 12 months postoperatively was (14.35 +/- 3.03) mm Hg (1 mm Hg = 0.133 kPa), which was distinctly lower than that of preoperative [(35.76 +/- 4.39) mm Hg (t = 25.39, P < 0.001)]. There was no significant difference between the two groups in the mean IOP preoperation and 1 week, 1 month, 3, 6, 12 months postoperation. The postoperative BCVA was between 0.2 and 1.2, BCVA < 0.3 was found in three eyes (7.5%), and > or = 0.3 in 37 eyes (92.5%), BCVA was significantly improved in 4 eyes after surgery (chi(2) = 31.03, P < 0.001). There was no obviously difference in visual acuity between the two groups at one week, 3 months postoperatively (chi(2) = 0.22, and 0.05, P > 0.05), the type I or II bleb formation was detected in 35 eyes (87.5%). Post operation, among the eyes, 13 eyes were single-incision while 22 eyes with double-incision. No severe postoperative complications were revealed in all of operated cases.

Conclusions: The procedures of combined phacoemulsification with trabeculectomy is safe, effective surgery for cataract patients combined with glaucoma. There were no differences in IOP, BCVA developing, bleb formation in early stage postoperatively using either single-incision or double-incision.