Combined trabeculectomy and cataract operation. A follow-up study.

In a study of 94 combined cataract and trabeculectomy operations performed for 59 open angle simplex and 35 capsular glaucoma with coexisting cataract, followed up for 1 to 9 years, the overall control of intraocular pressure (less than or equal to 21 mm Hg) without therapy was achieved in 61 eyes (65%). The average follow-up time was 3.4 years. The success rate 76% after 1 year follow-up decreased to 63% after 2 years and went from 45 to 66% over a 3 to 8 years follow-up period. Post-surgical therapy was required in 33 eyes (35%). Of these 31 eyes were controlled with medical therapy alone. In the light of the results the maintenance of filtration was considered the most important factor of success. Most frequent complications, transient hypotony (37%) and hyphaema (30%) had no significant effect on eventual success. As regards the diagnostic categories no significant difference existed in the success rates between the simplex and capsular glaucoma groups. The importance of periodic observation is discussed.