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Y. M. Buys, B. Zack, A. R. Slomovic, D. S. Rootman, G. E. Trope; Prospective Randomized Comparison of One- versus Two-Site Phacotrabeculectomy, Two Year Results. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5670.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate IOP lowering following one- versus two-site phacotrabeculectomy.
Eligible patients scheduled for phacotrabeculectomy were randomized to either one- or two-site surgery. Data recorded included demographics, visual acuity, IOP, endothelial cell counts, glaucoma medications, phacoemulsification settings, iris manipulation, suture lysis, needling and any complications. Follow-up data were obtained for 3, 6, 12 and 24 months.
80 patients were enrolled in the study and 75 completed 24 months follow-up. There were no significant differences between the groups pre-operatively. The mean IOP was 17.6 vs 17.6; 12.6 vs 12.5; 13.1 vs 11.7; 13.1 vs 12.7 and 12.5 vs 12.7 for one- vs two-site at baseline, 3, 6, 12 and 24 months respectively. There was a significant lowering of IOP compared to baseline for both groups at all time points (p< 0.05). There was no significant difference in mean IOP between the groups at any time. The mean number of glaucoma medications decreased from 3.0 in each group to 0.2 and 0.4 for one- and two-site respectively at 24 months (p=0.20). At 3 and 12 months, the endothelial counts were significantly lower in the two- versus one-site group, 2333 vs 2207 (p=0.17); 2239 vs 1938 (p=0.01), 2181 vs 1934 (p=0.04) and 2147 vs 1927 (p=0.05) for one- versus two-site at baseline, 3, 12 and 24 months respectively. The surgical time was significantly longer for two-site, 48.1+/-7.8, compared to one-site, 39.2+/-6.4 minutes, p<0.001.
At 2 years post phaco-trabeculectomy there was no statistically significant difference in IOP between the groups. Corneal endothelial cell counts were significantly lower in the two-site group at 3 and 12 months. Two-site surgery took significantly more time than one-site.
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