Objective: To investigate the results of combined phacoemulsification, intraocular lens implantation and trabeculectomy in Asian patients with primary angle closure glaucoma (PACG).
Methods: This was a retrospective non-comparative study of 55 consecutive patients (57 eyes) who underwent phacoemulsification, posterior chamber intraocular lens implantation and trabeculectomy for PACG at the Singapore National Eye Centre between 1997-98. The surgical outcome was assessed in terms of intraocular pressure (IOP), the incidence of complications and the visual acuity at last follow-up. The eyes were further categorized into two groups according to whether single-site or separate-site surgery was performed. Success was defined as final IOP < 21 mm Hg without medication and qualified success as final IOP < 21 mm Hg with medication. Patients with final IOP > 21 mm Hg, required further glaucoma surgery, lost light perception or became pthisical, were classified as failures.
Results: The mean follow up was 22.0 ± 5.6 months (mean ± SD). Success was achieved in 46 (81%) eyes, qualified success in 10 (17%) eyes, and failure in 1 (2%) eye. In terms of IOP outcome, the success rate was similar in the two surgical groups (single-site or separate-site). Forty-one eyes (72%) had 6/12 or better vision. There were no cases of intraoperative complications and the incidence of postoperative complications was low.
Conclusions: Combined phacoemulsification, intraocular lens implantation and trabeculectomy is associated with good intraocular pressure control and visual outcome in patients with PACG.