OBJECTIVETo describe the intraoperative and postoperative complications encountered during the first year of follow-up in the trabeculectomy alone versus combined phacotrabeculectomy in chronic angle-closure glaucoma (CACG) with coexisting cataract.

METHODSOne hundred and twenty patients aged 45 to 95 years who with CACG and coexisting cataract recruited into 2 randomized controlled trials comparing trabeculectomy alone vs combined phacotrabeculectomy were pooled for analysis.

The first trial recruited patients with trabeculectomy surgery controlled intraocular pressure, while the second trial recruited patients with combined phacotrabeculectomy to controlled intraocular pressure. All patients were reviewed every 1 month for one year after surgery. The main outcome measures include surgical complications, reoperation for complications, visual acuity, and cataract progression.

RESULTS 65 CACG eyes were randomized to receive trabeculectomy alone, and 55 eyes had combined phacotrabeculectomy. Intraoperative complications occurred in 3 patients (5%) in the trabeculectomy group and 4 patients (7%) in the combined phacotrabeculectomy group (P =0.60). Postoperative complications developed in 9 patients (14%) in the trabeculectomy group and 20 patients (36%) in the combined phacotrabeculectomy group during the first year of follow-up. The difference in the proportion of eyes with 1 or more surgical complications between the 2 treatment groups was statistically significant (P =0.007, Pearson chi test). There was no statistically significant difference in final visual acuity or glaucomatous progression during the 1 year follow-up. 

CONCLUSIONS The incidence of postoperative complications was higher after combined phacotrabeculectomy than trabeculectomy surgery during the first year of follow-up in the study, but most surgical complications were self-limited. Serious complications resulting in reoperation and/or vision loss occurred with similar frequency with both surgical procedures. There was no difference in visual acuity or disease progression between the 2 treatment groups.