The Efficacy of Phacotrabeculectomy in Reducing Intraocular Pressure

Abstract

Background: Primary open angle glaucoma and age related cataract are ocular comorbidities which can occur in some individuals at different times. Phacoemulsification is carried out for restoration of vision decreased by cataract while trabeculectomy is a procedure to decrease the intra ocular pressure. To save the time, money and stay in the hospital, phacotrabeculectomy is a single procedure which can fulfill both the restoration of vision and decrease intraocular pressure. Objectives: To determine the efficacy of phacotrabeculectomy in decreasing the intraocular pressure in patients having both primary open angle glaucoma and age related cataract.Materials and Methods: This study was conducted at the Eye department, Hayatabad Medical Complex, Peshawar, from 1st August, 2022 to 1st February 2023 after getting the permission from Ethical Committee to do this study. Patients both males and females, from 40-80 years of age, who had coexisting age related cataract (ARC) and Primary open angle glaucoma (POAG), whose intraocular pressures (IOP) was 21mm Hg or above, with and without using anti-glaucoma treatment.Patients who had secondary or rosette shaped cataract, past ocular trauma (including ocular surgery along with its intraoperative or post-operative complications) and trauma after phacotrabeculectomy procedure during the follow up period were excluded from this study.Results: All 121 patients underwent Phacotrabeculectomy. Follow up was done for 5 months. Preoperative mean intraocular pressure (IOP) was 23.53 ± 4.22SD which reduced to 12.90 ± 2.09SD postoperatively which was highly significant with p- value=0.001Conclusion: Phacotrabeculectomy reduced Intraocular pressure by >10 mm Hg in our study which showed that this procedure is very effective in coexisting age related cataract and primary open angle glaucoma.Keywords: Age related cataract, Angle closure glaucoma, Combined phaco-trabeculectomy, Glaucoma, Intraocular pressure, Open angle glaucoma, Trabeculectomy.