Objective: To evaluate and compare the results and complications of eyes that underwent a phaco-deep sclerectomy (DS) converted into phaco-trabeculectomy due to an intraoperative macroperforation with eyes undergoing uneventful phaco-DS.

Methods: The authors reviewed 106 eyes having a planned phaco-DS; 10 of them (9.4%) had to be converted into phaco-trabeculectomy because of a large perforation during the nonpenetrating procedure. Intraocular pressure (IOP), visual acuity, glaucoma medication evolution, and complications were evaluated and compared between groups.

Results: Eyes undergoing uneventful phaco-DS (n=96, Group 1) had a significantly higher postoperative IOP compared with those undergoing transformed phaco-trabeculectomy (n=10, Group 2) (p<0.05). One year postoperatively, 81.2% and 100% of the eyes in the Group 1 and 2, respectively, had an IOP pound 21 mmHg without treatment (p=0.206). One year postoperatively, eyes that underwent uneventful phaco-DS needed more glaucoma medications than eyes converted into phaco-trabeculectomy (p=0.014). Visual acuity improved more quickly in Group 1 (p<0.05). Hyphema and choroidal detachment rates were significantly higher in Group 2 (p=0.002 and p=0.027, respectively).

Conclusions: Phaco-DS converted into phaco-trabeculectomy provides better midterm IOP control when compared with uneventful phaco-DS, but has more complications and worse visual acuity in the early postoperative period.