INTRAOCULAR PRESSURE REDUCTION FOLLOWING COMBINED PHACOEMULSIFICATION AND TRABECULECTOMY SURGERY: A STUDY OF 300 CASES

Abstract

Objectives: The aim of the study was to evaluate intraocular pressure (IOP) reduction following combined phacoemulsification and trabeculectomy surgery in primary glaucomapatients with cataract. Methods: A prospective, comparative study of 300 patients with primary glaucoma and cataract who underwent combined surgery phacoemulsification and trabeculectomy at our center between July 2016 and June 2019 were included in this study. Out of these, 124 patients had primary open-angle glaucoma (POAG) and 176 patients had primary angle closure glaucoma (PACG). Phacoemulsification, intraocular lens implantation, and trabeculectomy were performed in all cases. Follow-up visits were carried out at 1, 3, and 6 months after surgery. Complete ophthalmic examination was done at each follow-up visit. Results: The pre-operative mean IOP of all patients was 34.60±6.33 mmHg and mean IOP at last 6 month follow-up was 13.0±2.18 mmHg. There was a statistically significant difference between IOP at presentation and IOP at 6-month follow-up (p<0.001). No significant difference in post-operative IOP in POAG and PACG patients (p>0.001). Out of 300, 58 patients required anti-glaucoma medication at 1 month and this number decreased to 41 patients at 6 month follow-up. No significant intraoperative complications were noted. Conclusion: Combined phacoemulsification and trabeculectomy surgery is safe and effective in controlling IOP with minimal complications in the management of primary glaucoma patients with cataract in expert hands.