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Abstract #77273 Published in IGR 19-3
Combined glaucoma and cataract surgery: Comparison of viscocanalostomy, endocyclophotocoagulation, and ab interno trabeculectomy
Moghimi S; Hamzeh N; Mohammadi M; Khatibi N; Bowd C; Weinreb RNJournal of Cataract and Refractive Surgery 2018; 44: 557-565
PURPOSE: To compare outcomes of phacoemulsification combined with viscocanalostomy, endocyclophotocoagulation (ECP), or ab interno trabulectomy for intraocular pressure (IOP) control and safety in eyes with open-angle glaucoma and visually significant cataract. SETTING: Farabi Eye Hospital, Tehran, Iran. DESIGN: Retrospective case series. METHODS: Medical records of patients who had combined surgery and were followed for at least 1 year were reviewed. Complete success, postoperative IOP, number of medications at each visit, and complications were evaluated and compared before and after adjustments for confounders. RESULTS: Forty-six eyes had combined phacoviscocanalostomy, 35 had phaco-ECP, and 28 eyes phaco-ab interno trabulectomy. The groups were matched for baseline IOP (P = .24). At the final follow-up (mean 17.2 months ± 5.5 [SD]), the phacoviscocanalostomy group had the lowest mean IOP (13.5 ± 4.7 mm Hg, 29% decrease) (P = .01). There was no significant difference in the final IOP between phaco-ECP and phaco-ab interno trabulectomy (16.4 ± 3.9 mm Hg, 20% decrease versus 15.8 ± 4.2 mm Hg, 15% decrease) (P = .88). The reduction in the number of medications was greater with phacoviscocanalostomy (77%) than with phaco-ECP (40%) and phaco-ab interno trabulectomy (44%) (P = .01). Phacoemulsification-ab interno trabulectomy had the fewest complications. Intraocular pressure spikes were more frequent in the phaco-ECP group (20%) than in the other groups (4%) (P = .05). CONCLUSIONS: All procedures significantly lowered IOP. Phacoemulsification-ab interno trabulectomy resulted in fewest complications and phacoviscocanalostomy led to the largest IOP drop and largest reduction of medications.
From the Hamilton Glaucoma Center (Moghimi, Bowd, Weinreb), Department of Ophthalmology, and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA; Tehran University of Medical Sciences (Moghimi, Hamzeh, Mohammadi, Khatibi), Tehran, Iran. Electronic address: sasanimii@yahoo.com.
Full articleClassification:
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.9 Trabeculotomy, goniotomy (Part of: 12 Surgical treatment)
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
