Comparison of extracapsular and phaco-emulsification cataract extraction techniques when combined with intra-ocular lens placement and trabeculectomy: short-term results.
BACKGROUND METHODS: Fifty patients who had undergone combined extracapsular cataract extraction (ECCE), intra-ocular lens (IOL) placement and trabeculectomy (ECCE-trab) and 50 who had undergone combined cataract phaco-emulsification, IOL placement and trabeculectomy (phaco-trab) were reviewed over a period of 12 months.


RESULTS
Postoperatively, intra-ocular pressure (IOP) in both eyes fell significantly (P < 0.005). Initially, IOP fell to roughly equal degrees (mean IOP being 14 mmHg at 3 months; P = 0.84). At 12 months, IOP in the phacotrab group was slightly lower than that in the ECCE-trab group (13.4+/-4.3 vs 15.4+/-4.4 mmHg, respectively; P = 0.0312). The number of pre-operative medications did not appear to affect outcome (P = 0.124). Visual recovery was approximately 3 months faster in the phaco-trab group. By 12 months there was little difference in visual acuity, with an average improvement of two Snellen lines (P = 0.68). The mean change in astigmatism was significantly less in the phaco-trab group (0.61+/-1.25 vs 1.39+/-1.46 D, respectively, P = 0.0063). Transient hypotony (IOP < 5 mmHg) was more frequent in the phaco-trab group (66 vs 32%, respectively; P < 0.002). The frequency of other complications was not significantly different between the two groups.


CONCLUSIONS
Both ECCE-trab and phaco-trab procedures are safe and effective. However, the phaco-trab procedure may have slightly improved IOP control, earlier visual recovery and less astigmatism.
Chia
W L
WL
Sydney Eye Hospital, New South Wales, Australia.
Goldberg
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D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications; D002387:Cataract Extraction / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity