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J. T. Gillespie, X. Liu, E. J. Rockwood, M. Jain, A. S. Maican; Outcomes of Phacoemulsification (PE) and Phacotrabeculectomy (PT) in Primary Open-Angle Glaucoma (POAG) at 3 Months and 1 Year. Invest. Ophthalmol. Vis. Sci. 2010;51(13):612.
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© ARVO (1962-2015); The Authors (2016-present)
To report outcomes of PE vs. PT in POAG patients from an outcomes database.
Prospective, nonrandomized, comparative, interventional case series of 110 eyes (110 patients) with POAG having PE and 160 eyes (160 patients) with POAG having PT between 1/1/06 and 12/31/08.
Mean preoperative intraocular pressure (IOP), ETDRS visual acuity (VA) and number of medications for the PE group were 15.8 ± 3.7, 58.9 ± 22.7, 1.0 ± 0.8, respectively, and for the PT group 20.1 ± 6.6, 57.4 ± 20.5, 2.4 ± 1.2, respectively. At 3 months, the mean IOP, VA and number of medications in the PE group were 15.7 ± 3.9, 74.7 ± 17.3, 0.8 ± 0.8, respectively, and for the PT group 16.9 ± 5.5, 67.4 ± 21.5, 0.1 ± 0.4, respectively. At 1 year, the mean IOP, VA and number of medications in the PE group were 15.6 ± 3.4, 75.1 ± 15.9, 0.8 ± 0.8, respectively, and for the PT group 15.3 ± 5.5, 70.2 ± 21.5, 0.2 ± 0.6, respectively. At 3 months, there was a significant association between baseline IOP with procedure and the expected 3 month IOP (p=0.03). The PE and PT group showed for every one unit increase in baseline IOP, the expected 3 month IOP would be increased by 0.3 and decreased by 0.1, respectively. However, at 1 year, there was no significant association (p=0.09) for VA and IOP. Both groups showed an increase of 0.2 mm Hg in the expected 1 year IOP for every unit increase in baseline IOP. VA, at 3 months, was significantly associated with baseline VA and procedure (p=0.02). The PE and PT groups showed for every letter increase in baseline VA, the expected 3 month VA increased 0.5 and 0.8 letters, respectively. At 1 year, there was no significant association (p=0.12). Both groups showed an increase of 0.6 letters in the expected 1 year visual acuity for every letter increase in visual acuity. POAG patients who had PE were 19.6 and 11.6 times more likely to be restarted on glaucoma medication at 3 months and 1 year, respectively when compared to patients with PT. (p= <0.001).
While both PE & PT have the ability to lower IOP at 1 year with reduction in medication, POAG patients who had PT had better IOP control at one year with significant reduction for the need for medication compared to patients having PE.
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