Combined non‐penetrating deep sclerectomy with phacoemulsification versus non‐penetrating deep sclerectomy alone

Abstract

Aims/Purpose: To compare the intraocular pressure after two surgical techniques: combined non‐penetrating deep sclerectomy with phacoemulsification (Phaco‐NPDS) and non‐penetrating deep sclerectomy (NPDS) alone.Methods: It is a retrospective study including thirty‐two patients with primary open angle glaucoma (POAG) or pseudoexfoliative glaucoma (PXG) who were not controlled with medication. They were assigned to Phaco‐NPDS (twenty‐two eyes) or NPDS (twenty eyes). Complications in surgery were noted and also, they were followed up after the surgery and intraocular pressure (IOP) was measured at one day, a month, six months and a year after the surgery. Moreover, best corrected visual acuity (BCVA) and the number of the anti‐glaucoma medications at the end of the postoperative medication was measured.Results: Mean IOP in the Phaco‐NPDS group decreased from 24.55 ± 5.8 mmHg to 17.31 ± 2.1 mmHg and in the NPDS group from 26.05 ± 4.1 to 15.6 ± 2.3 mmHg one day 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 3.31 ± 1.4 to 0.68 ± 0.2 and from 3.2 ± 1.3 to 0.3 ± 0.5 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).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.