Cataract-glaucoma combined surgery: comparison between phacoemulsification combined with deep sclerectomy, or trabeculectomy

Objective: To study the success rate of combined phaco-intraocular lens (IOL)-deep sclerectomy (P-DS), a new perforating filtering surgery, versus phaco-IOL-trabeculectomy (P-T).

Methods: Of 38 patients, 39 eyes with cataract and different types of glaucoma, 19 eyes underwent P-DS, and 20 eyes underwent P-T. Patients were prospectively studied.

Results: The follow-up of both groups was 11 +/- 6 months. The intraocular pressure (IOP) decrease in both groups was similar (from a mean preoperative IOP of 26.5 +/- 6.8 mmHg, to a mean postoperative IOP of 14.8 +/- 1.3 mmHg in the P-DS group, vs 25.9 +/- 7.7 mmHg preoperative and 14.8 +/- 2.7 mmHg postoperative in the P-T group). The visual acuity outcome was similar in both groups. The complication rate was significantly lower in the P-DS group.

Conclusions: Deep sclerectomy associated with cataract surgery offers the same IOP reduction and visual acuity outcome. However, the complication rate is significantly lower and allows easier ambulatory care.