title: Combined cataract and trabeculectomy surgery in eyes with pseudoexfoliation glaucoma.
abstract: OBJECTIVE
  To assess the short- and long-term effect of uneventful phacoemulsification, posterior chamber intraocular lens (IOL) implantation, and trabeculectomy on intraocular pressure (IOP) and glaucoma medication requirements in eyes with pseudoexfoliation glaucoma (PXG) and compare the results with those in eyes that had uneventful phacoemulsification only (reported in a previous study of the same cohort of pseudoexfoliation eyes).
  
  
  METHODS
  Private practice, Boston, Massachusetts, USA.
  
  
  METHODS
  Comparative case series.
  
  
  METHODS
  A retrospective analysis was performed of consecutive PXG eyes that had uneventful combined phacoemulsification and trabeculectomy by the same surgeon. The change in IOP, glaucoma medication requirements, and logMAR corrected distance visual acuity was compared between the combined surgery group and the phaco-alone group.
  
  
  RESULTS
  The combined-surgery group (n = 138) had statistically significant reduced mean IOP and glaucoma medication requirements through 10 years postoperatively (P<.018). The change in IOP and glaucoma medication requirements was greater in the combined-surgery group than in the phaco-alone group (n = 240); this was statistically significant up to 7 years postoperatively (P<.022). The reduction in mean postoperative IOP was greater in eyes with a higher mean preoperative IOP. In the combined-surgery group, 13.8% of eyes required subsequent laser trabeculoplasty, glaucoma surgery, or both.
  
  
  CONCLUSIONS
  Uneventful phacoemulsification, IOL implantation, and trabeculectomy resulted in significant long-term reduction in IOP and glaucoma medication requirements in eyes with PXG. Combined procedures resulted in greater and more longstanding reductions in IOP and glaucoma medication requirements and fewer 1-day postoperative IOP spikes than phacoemulsification alone.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors: Ophthalmic Consultants of Boston, Center for Eye Research and Education, Boston, Massachusetts, USA. bjshingleton@eyeboston.com
authors: Bradford J
authors: BJ
authors: Shingleton
authors: Kristy B
authors: KB
authors: Wooler
authors: Carla I
authors: CI
authors: Bourne
authors: Mark W
authors: MW
authors: O'Donoghue
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002386:Cataract / Q000150:complications / Q000503:physiopathology; D017889:Exfoliation Syndrome / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D032801:Iridectomy; D053685:Laser Therapy; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents