Phacotrabeculectomy Without Mitomycin C in Primary Angle-closure and Open-angle Glaucoma

Abstract

To compare the surgical outcomes of single site phacotrabeculectomy without mitomycin C (MMC) in primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG). We retrospectively reviewed the records of all patients with a diagnosis of PACG and POAG, who underwent single site phacotrabeculectomy without MMC between January 2001 and December 2005 and had a minimum follow-up of 12 months. The primary outcome measure was cumulative success probability, defined as complete [intraocular pressure (IOP) ≤21 mm Hg without antiglaucoma medications or additional surgery] and qualified (IOP <21 mm Hg with medications). Secondary outcome measures were reduction of IOP, the number of antiglaucoma medications at last follow-up, and complication rates. Seventy-one eyes of 63 PACG patients (mean age 61.2 y) and 72 eyes of 57 POAG patients (mean age 64.0 y) were analyzed. Mean duration of follow-up was 38.7 and 41.7 months in the PACG and POAG groups, respectively. Complete success in PACG (72.1%) was more than the POAG group (56.1%), but the difference was not statistically significant (P=0.06). Qualified success in the PACG and POAG group was 87.4% and 92.8%, respectively (P=0.43). IOP reduction was greater (P=0.03) in the PACG group and PACG group required fewer antiglaucoma medications postoperatively (P=0.03) for IOP control. Survival probability of single site phacotrabeculectomy without MMC was not significantly different between the PACG and POAG groups. IOP reduction was greater and the need for antiglaucoma medications after surgery was lesser in the PACG group.