Phacoemulsification Versus Phacotrabeculectomy in Primary Angle-closure Glaucoma with Cataract: Long-Term Clinical Outcomes

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. Precis:Phacotrabeculectomy was more effective in reducing intraocular pressure (IOP) and glaucoma drugs than phacoemulsification alone in primary angle-closure glaucoma (PACG) eyes with cataract but was associated with more postoperat...

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Main Authors: Linda Hansapinyo, Bonnie N.K. Choy, Jimmy S.M. Lai, Clement C. Tham
Format: Journal
Published: 2020
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/68544
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spelling th-cmuir.6653943832-685442020-04-02T15:29:04Z Phacoemulsification Versus Phacotrabeculectomy in Primary Angle-closure Glaucoma with Cataract: Long-Term Clinical Outcomes Linda Hansapinyo Bonnie N.K. Choy Jimmy S.M. Lai Clement C. Tham Medicine Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. Precis:Phacotrabeculectomy was more effective in reducing intraocular pressure (IOP) and glaucoma drugs than phacoemulsification alone in primary angle-closure glaucoma (PACG) eyes with cataract but was associated with more postoperative complications, up to 5 years after surgery.Purpose:The purpose of this study was to compare long-term clinical outcomes of phacoemulsification versus phacotrabeculectomy in PACG eyes with cataract.Patients and Methods:The 2 initial prospective randomized controlled trials recruited PACG eyes with cataract using the same criteria and randomized these eyes to receiving either phacoemulsification or phacotrabeculectomy. Clinical data up to 5 years of follow-up were pooled for retrospective analysis.Results:Clinical data of 35 patients in the phacoemulsification group and 44 patients in the phacotrabeculectomy group were analyzed. At 5 years after surgery, the mean IOP was decreased by 20.7% and 29.5% from before surgery to 5 years after phacoemulsification and phacotrabeculectomy, respectively (P<0.001 for both groups). Phacotrabeculectomy was significantly more effective than phacoemulsification in reducing IOP up to 5 years after surgery (P<0.001). At 5 years, the mean number of glaucoma drugs required±1 SD was 1.6±1.2 in the phacoemulsification group, and 0.7±1.0 in the phacotrabeculectomy group (P=0.004). Phacotrabeculectomy was associated with more postoperative complications than phacoemulsification up to 5 years (25 complications in the phacotrabeculectomy group versus 6 in the phacoemulsification group, P<0.001).Conclusions:Phacoemulsification alone reduces IOP and the need for glaucoma drugs in PACG eyes with cataracts for up to 5 years. Phacotrabeculectomy was more effective in reducing IOP and glaucoma drugs than phacoemulsification alone but was associated with more postoperative complications, up to 5 years after surgery. 2020-04-02T15:29:04Z 2020-04-02T15:29:04Z 2020-01-01 Journal 1536481X 10570829 2-s2.0-85074946946 10.1097/IJG.0000000000001397 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85074946946&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/68544
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Linda Hansapinyo
Bonnie N.K. Choy
Jimmy S.M. Lai
Clement C. Tham
Phacoemulsification Versus Phacotrabeculectomy in Primary Angle-closure Glaucoma with Cataract: Long-Term Clinical Outcomes
description Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. Precis:Phacotrabeculectomy was more effective in reducing intraocular pressure (IOP) and glaucoma drugs than phacoemulsification alone in primary angle-closure glaucoma (PACG) eyes with cataract but was associated with more postoperative complications, up to 5 years after surgery.Purpose:The purpose of this study was to compare long-term clinical outcomes of phacoemulsification versus phacotrabeculectomy in PACG eyes with cataract.Patients and Methods:The 2 initial prospective randomized controlled trials recruited PACG eyes with cataract using the same criteria and randomized these eyes to receiving either phacoemulsification or phacotrabeculectomy. Clinical data up to 5 years of follow-up were pooled for retrospective analysis.Results:Clinical data of 35 patients in the phacoemulsification group and 44 patients in the phacotrabeculectomy group were analyzed. At 5 years after surgery, the mean IOP was decreased by 20.7% and 29.5% from before surgery to 5 years after phacoemulsification and phacotrabeculectomy, respectively (P<0.001 for both groups). Phacotrabeculectomy was significantly more effective than phacoemulsification in reducing IOP up to 5 years after surgery (P<0.001). At 5 years, the mean number of glaucoma drugs required±1 SD was 1.6±1.2 in the phacoemulsification group, and 0.7±1.0 in the phacotrabeculectomy group (P=0.004). Phacotrabeculectomy was associated with more postoperative complications than phacoemulsification up to 5 years (25 complications in the phacotrabeculectomy group versus 6 in the phacoemulsification group, P<0.001).Conclusions:Phacoemulsification alone reduces IOP and the need for glaucoma drugs in PACG eyes with cataracts for up to 5 years. Phacotrabeculectomy was more effective in reducing IOP and glaucoma drugs than phacoemulsification alone but was associated with more postoperative complications, up to 5 years after surgery.
format Journal
author Linda Hansapinyo
Bonnie N.K. Choy
Jimmy S.M. Lai
Clement C. Tham
author_facet Linda Hansapinyo
Bonnie N.K. Choy
Jimmy S.M. Lai
Clement C. Tham
author_sort Linda Hansapinyo
title Phacoemulsification Versus Phacotrabeculectomy in Primary Angle-closure Glaucoma with Cataract: Long-Term Clinical Outcomes
title_short Phacoemulsification Versus Phacotrabeculectomy in Primary Angle-closure Glaucoma with Cataract: Long-Term Clinical Outcomes
title_full Phacoemulsification Versus Phacotrabeculectomy in Primary Angle-closure Glaucoma with Cataract: Long-Term Clinical Outcomes
title_fullStr Phacoemulsification Versus Phacotrabeculectomy in Primary Angle-closure Glaucoma with Cataract: Long-Term Clinical Outcomes
title_full_unstemmed Phacoemulsification Versus Phacotrabeculectomy in Primary Angle-closure Glaucoma with Cataract: Long-Term Clinical Outcomes
title_sort phacoemulsification versus phacotrabeculectomy in primary angle-closure glaucoma with cataract: long-term clinical outcomes
publishDate 2020
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85074946946&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/68544
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