Comparison of combined phacotrabeculectomy with trabeculectomy only in the treatment of primary angle-closure glaucoma  

作　　者：WANG Mei FANG Min BAI Yu-jing ZHANG Wei-zhong LIN Ming-kai LIU Bing-qian HAO Yuan-tao LING Yun-lan ZHUO Ye-hong GE Jian 

机构地区：[1]Department of Ophthalmology, the Second Affiliated Hospital, SunYat-sen University, Guangzhou, Guangdong 510120, China [2]Shenzhen Ophthalmic Center, Shenzhen Eye Hospital, JinanUniversity, Shenzhen, Guangdong 518000, China [3]Department of Ophthalmology, Peking University People＇sHospital, Beijing 100044, China [4]State Key Laboratory of Ophthalmology, Zhongshan OphthalmicCenter, Sun Yat-sen University, Guangzhou, Guangdong 510060,China [5]Department of Medical Statistics and Epidemiology, School ofPublic Health, Sun Yat-sen University, Guangzhou, Guangdong510040, China

出　　处：《Chinese Medical Journal》2012年第8期1429-1433,共5页中华医学杂志（英文版）

基　　金：This work was supported by a grant of Natural Science Foundation of Guangdong Province

摘　　要：Background Trabeculectomy has become a mainstream treatment in intraocular pressure （lOP） reduction for primary angle-closure glaucoma （PACG）; combined trabeculectomy and cataract surgery was reported to reduce lOP and simultaneously improve vision for patients with PACG and coexisting cataract. This study was specialized to compare the efficacy and safety of combined phacotrabeculectomy with that of trabeculectomy only in the treatment of PACG with coexisting cataract. Methods This is a comparative case series study. Thirty-one patients （31 eyes） with PACG and coexisting cataract were enrolled. Of these, 17 underwent phacotrabeculectomy and 14 underwent trabeculectomy alone, lOP, filtering blebs, and complications were compared at the final follow-up. Complete success was defined as a final lOP less than 21 mmHg without lOP-lowering medication. Results After 10 months of postoperative follow-up, the phacotrabeculectomy and trabeculectomy groups showed no significant differences regarding lOP reduction （（20.59±7.94） vs. （24.85±14.39） mmHg, P=0.614）, complete success rate （88% vs. 71%, P=0.370）, formation rate of functioning blebs （65% （11/17） vs. 93% （13/14）, P=0.094）, and complications （41% （7/17） vs. 57% （8/14）, P=0.380）. lOP-lowering medication was not required for most of the patients in both groups. Additional surgery interventions, including anterior chamber reformation and phacoemulsification, were needed in the trabeculectomy group, whereas no surgery was needed postoperatively in the phacotrabeculectomy group. Conclusion Phacotrabeculectomy and trabeculectomy treatments exhibit similar lOP reduction, successful rates, and complications when it comes to treating PACG patients with coexisting cataract, although additional surgery intervention may be needed for a few cases with cataract and complications after trabeculectomy.Background Trabeculectomy has become a mainstream treatment in intraocular pressure （lOP） reduction for primary angle-closure glaucoma （PACG）; combined trabeculectomy and cataract surgery was reported to reduce lOP and simultaneously improve vision for patients with PACG and coexisting cataract. This study was specialized to compare the efficacy and safety of combined phacotrabeculectomy with that of trabeculectomy only in the treatment of PACG with coexisting cataract. Methods This is a comparative case series study. Thirty-one patients （31 eyes） with PACG and coexisting cataract were enrolled. Of these, 17 underwent phacotrabeculectomy and 14 underwent trabeculectomy alone, lOP, filtering blebs, and complications were compared at the final follow-up. Complete success was defined as a final lOP less than 21 mmHg without lOP-lowering medication. Results After 10 months of postoperative follow-up, the phacotrabeculectomy and trabeculectomy groups showed no significant differences regarding lOP reduction （（20.59±7.94） vs. （24.85±14.39） mmHg, P=0.614）, complete success rate （88% vs. 71%, P=0.370）, formation rate of functioning blebs （65% （11/17） vs. 93% （13/14）, P=0.094）, and complications （41% （7/17） vs. 57% （8/14）, P=0.380）. lOP-lowering medication was not required for most of the patients in both groups. Additional surgery interventions, including anterior chamber reformation and phacoemulsification, were needed in the trabeculectomy group, whereas no surgery was needed postoperatively in the phacotrabeculectomy group. Conclusion Phacotrabeculectomy and trabeculectomy treatments exhibit similar lOP reduction, successful rates, and complications when it comes to treating PACG patients with coexisting cataract, although additional surgery intervention may be needed for a few cases with cataract and complications after trabeculectomy.

关 键 词：primary angle-closure glaucoma TRABECULECTOMY PHACOTRABECULECTOMY CATARACT 

分 类 号：TQ463[化学工程—制药化工] S858.292[农业科学—临床兽医学]