COMBINED TRABECULECTOMY AND PHACOEMULSIFICATION COMPARED TO TRABECULECTOMY ALONE, BOTH WITH MITOMYCIN C

G. Kleinmann, H. Katz, A. Pollack, E. Schechtman, R. Rachmiel and

M. Zalish

Department of Ophthalmology, Kaplan Medical Center, Israel

Objective: To compare the results of combined trabeculectomy with phacoemulsification and posterior chamber intraocular implantation (IOL) to those of trabeculectomy alone, with Mitomycin C (MMC) application in all cases.

Design: A retrospective comparative study of consecutive patients.

Participants: One hundred and two eyes of 90 pateints were studied in the combined procedure group, and 33 eyes of 30 patients in the trabeculectomy group.

Main Outcome Measures: Mean pre- and postoperative intraocular pressure (IOP), number of anti-glaucomatous medications used pre- and postoperative, functioning of the filtering bleb, and complications.

Results: Both groups showed a significant decrease in IOP, combined group, 6.755.7 mmHg (meanSD), p=0.0001; trabeculectomy group, 11.757.9 mmHg (meanSD), p=0.0001. The IOP decrease was significantly larger in the trabeculectomy group (p=0.0001). Postoperativly, the two groups showed similar significant reductions in the number of anti-glaucomtous medications used (combined group, o.821.0 compared with 2/650.84 preopratively, p=0.0001; trabeculectomy group, 0.761.2 compared with 2.70.95 preoperatively, p=0.0001). There were no cases of bleb leakage in the combined group and two cases (6%) in the trabeculectomy group.

Conclusion: Except for s significant larger postoperative IOP decrease in the patients who underwent trabeculectomy alone, the results of the combined procedure of phacoemulsification, posterior chamber IOL implantation and trbeculectomy with MMC application were as good as those of trabeculectomy alone with MMC.