title: Comparison of combined phacotrabeculectomy with trabeculectomy only in the treatment of primary angle-closure glaucoma.
abstract: BACKGROUND
  Trabeculectomy has become a mainstream treatment in intraocular pressure (IOP) reduction for primary angle-closure glaucoma (PACG); combined trabeculectomy and cataract surgery was reported to reduce IOP and simultaneously improve vision for patients with PACG and coexisting cataract. This study was specialized to compare the efficacy and safety of combined phacotrabeculectomy with that of trabeculectomy only in the treatment of PACG with coexisting cataract.
  
  
  METHODS
  This is a comparative case series study. Thirty-one patients (31 eyes) with PACG and coexisting cataract were enrolled. Of these, 17 underwent phacotrabeculectomy and 14 underwent trabeculectomy alone. IOP, filtering blebs, and complications were compared at the final follow-up. Complete success was defined as a final IOP less than 21 mmHg without IOP-lowering medication.
  
  
  RESULTS
  After 10 months of postoperative follow-up, the phacotrabeculectomy and trabeculectomy groups showed no significant differences regarding IOP reduction ((20.59 ± 7.94) vs. (24.85 ± 14.39) mmHg, P = 0.614), complete success rate (88% vs. 71%, P = 0.370), formation rate of functioning blebs (65% (11/17) vs. 93% (13/14), P = 0.094), and complications (41% (7/17) vs. 57% (8/14), P = 0.380). IOP-lowering medication was not required for most of the patients in both groups. Additional surgery interventions, including anterior chamber reformation and phacoemulsification, were needed in the trabeculectomy group, whereas no surgery was needed postoperatively in the phacotrabeculectomy group.
  
  
  CONCLUSIONS
  Phacotrabeculectomy and trabeculectomy treatments exhibit similar IOP reduction, successful rates, and complications when it comes to treating PACG patients with coexisting cataract, although additional surgery intervention may be needed for a few cases with cataract and complications after trabeculectomy.
authors.affiliation: Department of Ophthalmology, the Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Wang
authors.forename: Min
authors.initials: M
authors.lastname: Fang
authors.forename: Yu-jing
authors.initials: YJ
authors.lastname: Bai
authors.forename: Wei-zhong
authors.initials: WZ
authors.lastname: Zhang
authors.forename: Ming-kai
authors.initials: MK
authors.lastname: Lin
authors.forename: Bing-qian
authors.initials: BQ
authors.lastname: Liu
authors.forename: Yuan-tao
authors.initials: YT
authors.lastname: Hao
authors.forename: Yun-lan
authors.initials: YL
authors.lastname: Ling
authors.forename: Ye-hong
authors.initials: YH
authors.lastname: Zhuo
authors.forename: Jian
authors.initials: J
authors.lastname: Ge
mesh_terms: D000368:Aged; D002387:Cataract Extraction; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D014130:Trabeculectomy / Q000009:adverse effects / Q000379:methods*; D014792:Visual Acuity