Evaluation of visual and surgical outcomes after phacotrabeculectomy in patients with primary open angle and primary closed angle glaucomas

• Published in: Kerala journal of ophthalmology Vol. 28; no. 1; pp. 27 - 32
• Main Authors: Manju, C, Verghese, Amita, Joseph, Verghese
• Format: Journal Article
• Language: English
• Published: Medknow Publications and Media Pvt. Ltd 01-01-2016; Wolters Kluwer Medknow Publications
• Subjects: Angle-closure glaucoma; Care and treatment; Cataract; Glaucoma; intraocular pressure; phacotrabeculectomy; visual acuity; Open-angle glaucoma; Patient outcomes; Surgery; Trabeculectomy; India
• ISSN: 0976-6677; 0976-6677
• DOI: 10.4103/0976-6677.193875

Introduction: Both glaucoma and cataract often coexist in the elderly population. In these patients, a combined surgery has advantages such as improved vision and intraocular pressure (IOP) reduction in a single sitting. Aim: The aim of this study was to evaluate the effectiveness and safety of the combined procedure in patients with coexisting cataract and primary open or closed-angle glaucoma. Materials and Methods: A prospective study was conducted which included 20 eyes of 17 patients planned for phacotrabeculectomy procedure. Preoperative evaluation included detailed ocular examination for the grade of cataract, glaucoma evaluation, and exclusion of ocular comorbidities. A superior trabeculectomy with mitomycin C and temporal phacoemulsification with in the bag intraocular lens implantation was performed. Postoperatively, improvement in the best corrected visual acuity, IOP control, and reduction in the number of antiglaucoma medications was evaluated. Patients were followed for a 6-month period. Results: Postoperatively, all the patients had significant improvement in best corrected visual acuity (P < 0.0001) and significant reduction in IOP. The usage of antiglaucoma medication was lower (P < 0.0001) and 85% percent (17 eyes) had no complications. Conclusion: Combined phacoemulsification and trabeculectomy is an effective and safe procedure to provide good visual acuity and control of intraocular pressure at the same time.