Trabeculotomy combined with phacoemulsification and implantation of intraocular lens for primary open-angle glaucoma

Abstract

Retrospective study examined the surgical effects of lowering intraocular pressure of trabeculotomy combined with phacoemulsification and implantation of an intraocular lens. Included in the retrospective study were 96 eyes of 64 patients with primary open-angle glaucoma. Preoperative mean IOP was 25.6 mmHg. At final examination, the IOP was well-controlled at 21 mmHg or lower without medications in 32 of 96 eyes. In another 62 eyes, the IOP was well-controlled with antiglaucoma medications. The postoperative IOPs were in the high teens after surgery. The life table analysis using Kaplan-Meier methods showed that the success probability after phacoemulsification and implantation of intraocular lens, combined with trabeculotomy (PIT)-I and PIT-II, were 93.9% and 82.6% at 4 years, respectively. Postoperative visual acuity improved by more than two lines in 79 of the 96 eyes. In no case was the visual acuity decreased by more than two lines. Deterioration of the visual field was found in 4 eyes. There were no complications such as shallow anterior chamber, choroidal detachment, malignant glaucoma, hypotonic maculopathy, and endophthalmitis. This triple procedure should be performed in the early stages of glaucoma.