title: Combined non-penetrating deep sclerectomy with phacoemulsification versus non-penetrating deep sclerectomy alone.
abstract: OBJECTIVE
  To compare the results of combined non-penetrating deep sclerectomy with phacoemulsification (Phaco-NPDS) to those of non-penetrating deep sclerectomy (NPDS) alone.
  
  
  METHODS
  Fifty-two eyes with cataract and primary open angle glaucoma (POAG) or pseudoexfoliative glaucoma (PXG) were randomly assigned to either Phaco-NPDS or NPDS. Follow-up was performed at regular intervals for up to 36 months. Complete success was defined as intraocular pressure (IOP) <21 mmHg without medication and qualified success was defined as IOP <21 mmHg with medication.
  
  
  RESULTS
  Mean IOP in the Phaco-NPDS group decreased from 23.0 ± 7.8 mmHg to 14.1 ± 2.8 mmHg and in the NPDS group from 23.5 ± 5.1 to 14.6 ± 2.2 mmHg 24 months after surgery. The decreases of IOP in the postoperative period were statistically significant in both groups (p < 0.05). There was no significant IOP difference between Phaco-NPDS and NPDS patients postoperatively (p > 0.05). The mean number of glaucoma medications decreased from 1.8 ± 1.3 to 0.15 ± 0.4 and from 1.7 ± 1.4 to 0.22 ± 0.6 in the Phaco-NPDS and NPDS groups, respectively. The decreases in the mean number of the anti-glaucoma medications at the end of the postoperative, 24-month follow-up period were found to be statistically significant for both Phaco-NPDS and NPDS groups (p < 0.05). Mean BCVA increased significantly in both groups. However, the visual outcome was significantly better for the Phaco-NPDS group (p < 0.05). The complete and qualified success rates were 65.3% and 88.4% for Phaco-NPDS patients and 73.1% and 92.3% for NPDS patients, respectively (p > 0.05).
  
  
  CONCLUSIONS
  Phaco-NPDS surgery achieved excellent IOP control, while also providing immediate visual recovery. The success rate was similar to that of the NPDS procedure alone. It is advisable to consider Phaco-NPDS as a primary surgery for patients with coexisting cataract and open angle glaucoma, including PXG.
authors: Hacettepe University Beytepe Health Center , Ankara , Turkey and.
authors: Gorkem
authors: G
authors: Bilgin
authors: Ahmet
authors: A
authors: Karakurt
authors: M Sinan
authors: MS
authors: Saricaoglu
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002386:Cataract / Q000150:complications; D017889:Exfoliation Syndrome / Q000601:surgery; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery*; D012599:Sclerostomy / Q000379:methods*; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents