Combined trabeculectomy and cataract extraction versus trabeculectomy alone in primary angle-closure glaucoma.
OBJECTIVE
To compare the long-term efficacy and safety of combined trabeculectomy and cataract extraction versus trabeculectomy alone in primary angle-closure glaucoma (PACG).


METHODS
Hospital files were retrospectively examined for 99 Chinese PACG patients; 75 patients underwent combined surgery and 24 underwent trabeculectomy alone. Success rates were assessed with the Kaplan-Meier survival analysis. The main outcome was the complete success rate defined as either a >20% reduction in intraocular pressure (IOP) or an IOP that remained below 15 mm Hg, with no medications required.


RESULTS
Patients in the combined group and trabeculectomy group had a mean follow-up period of 25.8 (SD 10.8) months and 31.4 (8.9) months, respectively. Survival analysis showed that the complete success rate at 3 years was 56% in the combined group and 54% in the trabeculectomy group (p = 0.903). There were no significant differences between groups in either IOP or the number of glaucoma medications throughout the 3-year follow-up. The incidences of postoperative complications were similar between groups (p = 0.232). No additional IOP-lowering surgical procedures were required in the combined group, while 13 (54%) eyes in the trabeculectomy group required either cataract extraction or further IOP-lowering surgical procedures (p <0.001).


CONCLUSIONS
In patients with PACG, the long-term IOP-lowering effect and surgical complications of combined trabeculectomy and cataract extraction are comparable with those of trabeculectomy alone. However, the combined surgery incurred fewer subsequent surgical interventions.
Tsai
H-Y
HY
Institute of Clinical Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan.
Liu
C J
CJ
Cheng
C-Y
CY
D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology