Intraocular Pressure Control after Trabeculectomy, Phacotrabeculectomy and Phacoemulsification in a Hispanic Population.

PURPOSE: To compare the efficacy of different surgical strategies for intraocular pressure (IOP) control in Hispanic glaucoma patients with and without visually significant cataracts.

DESIGN

Comparative retrospective consecutive case series.

METHODS

The charts of 153 consecutive patients with primary open angle glaucoma who underwent either trabeculectomy alone (n = 51), phacotrabeculectomy (n = 51), or phacoemulsification alone (n = 51) were reviewed to compare IOP control, the number of glaucoma medications required postoperatively, and the inci dence of surgical complications.

RESULTS

Preoperative IOP was 17.5 ± 5.2 mm Hg in the trabe-culectomy group, 15.4 ± 4.5 mm Hg in the phacotrabeculectomy group and 13.9 ± 2.9 mm Hg in the phacoemulsification group (p < 0.001 for all comparisons). Mean IOP reduction from baseline was 4.2 ± 6.9 (24.6%) for the trabeculectomy group, 2.9 ± 5.0 (20.8%) for the phacotrabeculectomy group, and 0.9 ± 3.4 (6.5%) for the phacoemulsification group (p = 0.009). The number of IOP-lowering medications required postoperatively decreased significantly in all three groups (p = 0.001). The rate of early and late postoperative complications was similar between the trabeculectomy and phacotrabeculectomy groups and less for the phacoemulsification group.

CONCLUSION

Trabeculectomy and phacotrabeculectomy are both viable surgical options for managing open angle glau coma. Both resulted in similar rates of success, IOP reduction, decrease in use of IOP-lowering medications and post operative complication rates. Phacoemulsification alone had a lower success rate and greater need for postoperative IOP-lowering medications compared to trabeculectomy alone or phacotrabeculectomy. Phacoemulsification alone may be a reasonable option for patients with visually significant cataract and lower baseline IOP. How to cite this article: Jung JL, Isida-Llerandi CG, Lazcano-Gomez G, SooHoo JR, Kahook MY. Intraocular Pressure Control after Trabeculectomy, Phacotrabeculectomy and Phaco-emulsification in a Hispanic Population. J Curr Glaucoma Pract 2014;8(2):67-74.