Combined Phaco Trabeculectomy Vs Combined ECCE Trabeculectomy with IOL Implantation

Abstract

Purpose: Evaluation and comparison of IOP control and visual outcome after phacotrabeculectomy and conventional combined surgery in cases of co-existing cataract and primary open angle glaucoma.

Material and Methods: This case control prospective study included the review of 50 patients who had undergone combined phacoemulsification with IOL implantation and trabeculectomy (phacotrab group and 50 who had undergone combined ECCE, IOL implantation and trabeculectomy (ECCE trab group), over a period of 12 months. Evaluation was based on IOP control, visual outcome and rate of complications.

Results: Postoperative IOP in both groups fell significantly (P=<0.05) below the preoperative medically controlled IOP. At initial 2 months postoperative IOP was almost similar in bothgroups (mean IOP in phacotrab group was 11 mm Hg vs mean IOP in ECCE trab group as 13 mm Hg i.e P= >.050). At 12 months, the IOP in phacotrab group was lower than ECCE trab group. Postoperative visual recovery was much better and faster in phacotrab group than in ECCE trab group. The frequency of complication was significantly higher in ECCE trab group.

Conclusion: Phacotrabeculectomy provides more effective and sustained IOP control and early visual recovery as compared to ECCE trabeculectomy.