Combined Cataract And Glaucoma Surgery – Recent Sydney Experience

1. Katherine Masselos^1,2
2. Jed Lusthaus^2,3
3. David Wechsler^2,4,5
4. Ashish Agar^1,2

¹Prince of Wales Hospital, Sydney, Australia
²University of NSW, Sydney, Australia
³Sydney Eye Hospital, Sydney, Australia
⁴Liverpool Hospital, Sydney, Australia
⁵Concord Hospital, Sydney, Australia.

Purpose: To report the outcomes of patients who underwent phacoemulsification combined with trabeculectomy for management of glaucoma.

Methods: Retrospective case review of the past 21 consecutive patients (23 eyes) who had combined phacoemulsification and trabeculectomy procedures. Intraocular pressure and visual acuity pre and post operatively were recorded as was the need for subconjunctival injection of 5-fluorouracil or a needling procedure. Use of topical glaucoma medication at follow up was also assessed.

Results: Patients were followed for a minimum of 6 months. Pre operative visual acuity improved or remained stable in 21 eyes. Mean preoperative visual acuity was 6/12 improving to 6/9 postoperatively. Average intraocular pressure reduction was 47%, with one patient having higher intraocular pressures post procedure. Mean preoperative intraocular pressure was 25, falling to 12 postoperatively. 87% of patients did not require glaucoma medications postoperatively. Needling was performed on 6 eyes, with a maximum of only one needling per eye. 18 eyes needed injections of 5-fluorouracil.

Conclusion: Combined phacoemulsification trabeculectomy surgery is an effective procedure and may be considered in glaucoma patients on maximal medical therapy with visually significant cataract.