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Br J Ophthalmol 2009;93:943-948 doi:10.1136/bjo.2008.151803
  • Clinical science
    • Original Article

Combined trabeculectomy and cataract extraction versus trabeculectomy alone in primary angle-closure glaucoma

  1. H-Y Tsai1,2,3,
  2. C J Liu2,4,
  3. C-Y Cheng2,4,5
  1. 1
    Institute of Clinical Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan
  2. 2
    Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
  3. 3
    Division of Ophthalmology, Chutung Veterans Hospital, Chutung, Hsin Chu County, Taiwan
  4. 4
    Department of Ophthalmology, National Yang Ming University School of Medicine, Taipei, Taiwan
  5. 5
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  1. Dr C-Y Cheng, Department of Ophthalmology, National Yang Ming University School of Medicine and Taipei Veterans General Hospital, 201 Sec 2 Shihpai Rd, Taipei 112, Taiwan; cycheng{at}jhsph.edu
  • Accepted 28 February 2009
  • Published Online First 20 April 2009

Abstract

Aims: To compare the long-term efficacy and safety of combined trabeculectomy and cataract extraction versus trabeculectomy alone in primary angle-closure glaucoma (PACG).

Methods: Hospital files were retrospectively examined for 99 Chinese PACG patients; 75 patients underwent combined surgery and 24 underwent trabeculectomy alone. Success rates were assessed with the Kaplan–Meier survival analysis. The main outcome was the complete success rate defined as either a >20% reduction in intraocular pressure (IOP) or an IOP that remained below 15 mm Hg, with no medications required.

Results: Patients in the combined group and trabeculectomy group had a mean follow-up period of 25.8 (SD 10.8) months and 31.4 (8.9) months, respectively. Survival analysis showed that the complete success rate at 3 years was 56% in the combined group and 54% in the trabeculectomy group (p = 0.903). There were no significant differences between groups in either IOP or the number of glaucoma medications throughout the 3-year follow-up. The incidences of postoperative complications were similar between groups (p = 0.232). No additional IOP-lowering surgical procedures were required in the combined group, while 13 (54%) eyes in the trabeculectomy group required either cataract extraction or further IOP-lowering surgical procedures (p <0.001).

Conclusion: In patients with PACG, the long-term IOP-lowering effect and surgical complications of combined trabeculectomy and cataract extraction are comparable with those of trabeculectomy alone. However, the combined surgery incurred fewer subsequent surgical interventions.

Footnotes

  • Competing interests: None.

  • Ethics approval: Ethics approval was provided by Taipei Veterans General Hospital.

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