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Ani Khondkaryan, Brian A. Francis; Combined Trabectome Phacoemulsification versus Phacoemulsification Alone in Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5938.
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To compare Trabectome surgery combined with phacoemulsification with phacoemulsification alone in eyes with open angle glaucoma and cataract.
This is a prospective, comparative cohort study of 60 eyes that underwent Trabectome with phacoemulsification and 20 eyes that underwent phacoemulsification. The inclusion criteria were open angle glaucoma and visually significant cataract, preoperative IOP of 18mmHg or greater, and minimum of 24 months of follow up. Primary out comes were intraocular pressure (IOP) and glaucoma medications.
The average pre-operative IOP in both the groups were: Combined Trabectome Phaco group 23.5+ 4.7 mmHg and Phaco only group 21.4+ 2.9 mmHg, p=0.02. The mean IOP at 12 and 24months are: Combined group 15.9+2.8mmHg, 15.8±3.0mmHg, and Phaco only group16.8+3.9mmHg, 17.5±3.7mmHg respectively. The IOP dropped by 30% (p<0.01) in the combined group and 17% in the Phaco only group (p<0.01) at 24months. The average pre-op glaucoma medications in the combined group are 2.38+1.04. At 24 months follow-up, the medications significantly dropped to 1.56+1.23 (p<0.01) in combined group. The glaucoma medications in Phaco only group reduced from 1.40±1.47mmHg to 0.80±1.11mmHg at 24 months (p=0.15).
The reduction in IOP and glaucoma medications after phacoemulsification is less than the reduction after combined Trabectome and phacoemulsification in patients with open angle glaucoma and cataract. Trabectome combined with Phacoemulsification is more effective in lowering IOP than phacoemulsification alone.
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