title: Trabeculectomy and phaco-trabeculectomy with and without peripheral iridectomy.
abstract: OBJECTIVE
  To compare the 1-year outcome of trabeculectomy and combined phaco-trabeculectomy that were performed with or without a peripheral iridectomy (PI).
  
  
  METHODS
  In a large tertiary glaucoma clinic, with a single surgeon performing all surgeries, 47 patients scheduled to undergo either a primary trabeculectomy or phaco-trabeculectomy were prospectively randomized to surgery with or without peripheral iridectomy. Other than the inclusion (PI group) or omission (no PI group) of a PI, surgical technique and postoperative care were identical for the two groups. The two groups were compared for intraocular pressure (IOP), success rates, visual acuity (VA), and complication rates. Complete and qualified success rates were defined as IOP 18 mmHg or less with or without medications, respectively.
  
  
  RESULTS
  The 1-year complete and qualified success rates were comparable for both groups. Complete success was observed in 70% of cases, and qualified success in more than 90%. One patient (4.3%) from the no-PI group developed an iris incarceration into the internal sclerectomy site on postoperative day 1, requiring surgical intervention. No other significant complications (blebitis, endophthalmitis, or choroidal hemorrhage) were encountered in any of the study patients.
  
  
  CONCLUSIONS
  This randomized prospective small scale study explored the possibility of sparing the need to perform a routine PI in trabeculectomy and phaco-trabeculectomy. These preliminary results suggest that the outcomes in the two groups are comparable, paving the way to a larger scale study evaluating the need for PI in modern trabeculectomy surgery.
authors.affiliation: Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel. audreykap@gmail.com
authors.forename: Audrey
authors.initials: A
authors.lastname: Kaplan-Messas
authors.forename: Yuval
authors.initials: Y
authors.lastname: Cohen
authors.forename: Eytan
authors.initials: E
authors.lastname: Blumenthal
authors.forename: Isaac
authors.initials: I
authors.lastname: Avni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000517:prevention & control; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D032801:Iridectomy; D007498:Iris / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity