title: Comparison of trabeculectomy with mitomycin C with or without phacoemulsification and lens implantation.
abstract: OBJECTIVE
  To compare the results of combined trabeculectomy with phacoemulsification and posterior chamber intraocular lens (IOL) implantation to those of trabeculectomy alone using mitomycin C (MMC) application intraoperatively in all cases.
  
  
  METHODS
  A retrospective comparative study of consecutive patients was conducted on two groups: 102 eyes of 90 patients studied in the combined procedure group, and 33 eyes of 30 patients in the trabeculectomy alone group.
  
  
  RESULTS
  Both groups showed a significant decrease in IOP. The combined group had a change from 21.5+/-5.8 mm HG preoperative to 14.73+/-3.44 mm HG postoperative, P=0.0001; the trabeculectomy group changed from 24.2+/-7.5 mm HG preoperative to 12.46+/-3.86 mm HG postoperative, P=0.0001. This represents a 31.5% reduction in IOP in the combined group versus a 48.5% reduction in the trabeculectomy alone group (P=0.0001). The follow-up time was longer in the trabeculectomy group (trabeculectomy group, 22.6+/-13.3 months; combined group, 14.2+/-8.0 months), P=0.0014. There were 97 eyes in the combined group (95%) and 32 eyes (97%) in the trabeculectomy group that had an IOP of less than 20 mm HG at the end of follow up. Postoperatively, the two groups showed similar significant reductions in the number of antiglaucomatous medications used (combined group, 0.82+/-1.0 compared with 2.65+/-0.84 preoperatively, P=0.0001; trabeculectomy group, 0.76+/-1.2 compared with 2.7+/-0.95 preoperatively, P=0.0001). There were no cases of bleb leakage in the combined group and two cases (6%) in the trabeculectomy group.
  
  
  CONCLUSIONS
  The reduction of IOP is significantly larger after trabeculectomy alone than after the combined procedure; however, the functional and anatomical results of the combined procedure of phacoemulsification, posterior chamber IOL implantation, and trabeculectomy with MMC application were as good as those of trabeculectomy alone with MMC.
authors.affiliation: Department of Ophthalmology, Kaplan Medical Center Rehovot, Israel.
authors.forename: Guy
authors.initials: G
authors.lastname: Kleinmann
authors.forename: Haia
authors.initials: H
authors.lastname: Katz
authors.forename: Ayala
authors.initials: A
authors.lastname: Pollack
authors.forename: Edna
authors.initials: E
authors.lastname: Schechtman
authors.forename: Roni
authors.initials: R
authors.lastname: Rachmiel
authors.forename: Miriam
authors.initials: M
authors.lastname: Zalish
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D002386:Cataract / Q000150:complications / Q000628:therapy*; D005901:Glaucoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D018918:Phacoemulsification / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin