Phacotrabeculectomy linked to higher complication rate compared with phaco alone

Researchers pooled data from two trials of patients with chronic angle-closure glaucoma and cataract who were randomized to either phacoemulsification alone (62 eyes) or phacotrabeculectomy with adjunctive mitomycin C chemotherapy (61 eyes).

The two trials were identical in design; with the exception that one recruited patients with medically controlled IOP, while the other recruited patients with medically uncontrolled IOP.

During two years of follow-up, the complication rate was 8.1 percent in the phaco group, compared to 26.2 percent in the phacotrabeculectomy group. There was no significant difference in visual acuity or disease progression between the two groups.

Even though the study did not demonstrate any statistically significant differences in outcomes, the authors note that surgical complications are no doubt associated with more clinic visits, more operative time, inconveniences, financial costs to patients and society, and negative emotions for patients and health care professionals - all of which should be taken into consideration when deciding whether to perform combined phacotrabeculectomy or phacoemulsification alone for any patient with chronic angle-closure glaucoma.

This study also lends support to those who argue that cataract surgery just may be the best glaucoma surgery.