Comparison of combined cataract and glaucoma surgery using planned extracapsular and phacoemulsification techniques.
OBJECTIVE
The surgical management of coexisting cataract and glaucoma is a common problem for the ophthalmologist.


METHODS
We evaluated intraocular pressure (IOP) reduction and bleb formation in combined cataract and filtration surgery, comparing planned extracapsular cataract extraction (ECCE) and phacoemulsification approaches coupled with similar trabeculectomy techniques. Seventy-two eyes with primary open-angle or pseudoexfoliation glaucoma underwent combined cataract and filtration surgery. Thirty-five eyes underwent planned ECCE, intraocular lens (IOL) implantation, and trabeculectomy, and 37 eyes underwent phacoemulsification, IOL implantation and trabeculectomy. Minimum follow-up for both groups was 1 year with a mean of 16 months.


RESULTS
The mean IOP reduction for phacoemulsification/trabeculectomy eyes (5.0 +/- 4.3 mm Hg) was significantly lower than the mean IOP reduction for ECCE/trabeculectomy eyes (2.9 +/- 4.1 mm Hg; P < 0.03). There was no significant difference between the groups in terms of visual acuity improvement or glaucoma medication reduction.


CONCLUSIONS
Combined cataract and filtration surgery using phacoemulsification is associated with greater IOP reduction than combined surgery using ECCE.
Shingleton
B J
BJ
Center for Eye Research, Boston, MA, USA.
Jacobson
L M
LM
Kuperwaser
M C
MC
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D018918:Phacoemulsification; D011184:Postoperative Period; D012189:Retrospective Studies; D014130:Trabeculectomy; D014792:Visual Acuity