Results of Combined Phacoemulsification and Trabeculectomy in Patients with Elevated Preoperative Intraocular Pressures

Abstract

We evaluated the results of 17 consecutive patients with high intraocular pressures and visually significant cataracts who underwent combined phacoemulsification and trabeculectomy. We individually matched each patient by age, race, and intraocular pressure (trabeculectomy group only) to two control groups: group 1, patients who had combined phacoemulsification and trabeculectomy and whose intraocular pressures were controlled preoperatively (pressure </=18 mm Hg), and group 2, patients who had high intraocular pressures preoperatively and trabeculectomy alone. Only patients with chronic open-angle glaucoma undergoing initial filtration surgery were included. One year postsurgery there was no statistically significant difference between study patients and either control group in terms of intraocular pressure (p > 0.05). Moreover, no statistical difference was observed between groups at 1 year postsurgery in number of glaucoma medications, bleb height or extent, anterior chamber depth, or bleb vascularity (p > 0.05). Additionally, both study and control patients had a statistically similar peak pressure the first month following surgery (p > 0.05). Complications were similar among groups. This study suggests that patients with chronic open-angle glaucoma and high intraocular pressure may undergo combined trabeculectomy and phacoemulsification and achieve long-term postoperative intraocular control similar to those patients who have trabeculectomy only or a combined procedure and controlled preoperative pressure.