PURPOSE: We retrospectively evaluated the results of combined phacoemulsification and trabeculectomy through scleral tunnel incision in comparison with those of goniotrephination alone. PATIENTS AND METHODS: 27 eyes of 20 patients (78.3 +/- 7.45 years) underwent a combined trabeculectomy and phacoemulsification with IOL-implantation (PT-group). The trabeculectomy was performed by excision of 2 mm middle part of the lower tunnel lip. In comparison with the TP-group 29 eyes of 28 patients (69.3 +/- 8.1 years) underwent a goniotrephination (Fronimopoulos), (G-group). The median of follow up was 8 weeks. RESULTS: In both groups a significant reduction of the IOP was achieved; in the PT-group the IOP was reduced from 31.0 +/- 5.42 to 15.0 +/- 4.5 mm Hg, in the G-group from 31.4 +/- 6.3 to 11.6 +/- 4.12 mmHg. In the PT-group the visual acuity increased significantly from 0.25 +/- 0.14 to 0.37 +/- 0.27 and decreased significantly from 0.46 +/- 0.28 to 0.32 +/- 0.25 in the G-group. 3 patients (= 11%) needed topical medication in the PT-group and 6 (= 24%) in the G-group. Four patients (= 15%) of the PT-group underwent a secondary surgery and 7 (= 24%) of the G-group. CONCLUSIONS: The combined phacoemulsification and trabeculectomy is a successful method of IOP control and visual rehabilitation. Due to the decrease of visual acuity and a higher frequency of secondary surgery after goniotrephination alone the combined procedure should be preferred even in presence of a moderately visual acuity reducing cataract.
PURPOSE: We retrospectively evaluated the results of combined phacoemulsification and trabeculectomy through scleral tunnel incision in comparison with those of goniotrephination alone. PATIENTS AND METHODS: 27 eyes of 20 patients (78.3 +/- 7.45 years) underwent a combined trabeculectomy and phacoemulsification with IOL-implantation (PT-group). The trabeculectomy was performed by excision of 2 mm middle part of the lower tunnel lip. In comparison with the TP-group 29 eyes of 28 patients (69.3 +/- 8.1 years) underwent a goniotrephination (Fronimopoulos), (G-group). The median of follow up was 8 weeks. RESULTS: In both groups a significant reduction of the IOP was achieved; in the PT-group the IOP was reduced from 31.0 +/- 5.42 to 15.0 +/- 4.5 mm Hg, in the G-group from 31.4 +/- 6.3 to 11.6 +/- 4.12 mmHg. In the PT-group the visual acuity increased significantly from 0.25 +/- 0.14 to 0.37 +/- 0.27 and decreased significantly from 0.46 +/- 0.28 to 0.32 +/- 0.25 in the G-group. 3 patients (= 11%) needed topical medication in the PT-group and 6 (= 24%) in the G-group. Four patients (= 15%) of the PT-group underwent a secondary surgery and 7 (= 24%) of the G-group. CONCLUSIONS: The combined phacoemulsification and trabeculectomy is a successful method of IOP control and visual rehabilitation. Due to the decrease of visual acuity and a higher frequency of secondary surgery after goniotrephination alone the combined procedure should be preferred even in presence of a moderately visual acuity reducing cataract.