Ophthalmology Clinic, University of Ioannina, 45500 Ioannina, Greece.
2nd Department of Ophthalmology, University of Athens, 12462 Athens, Greece.
Medicina (Kaunas). 2023 Feb 27;59(3):470. doi: 10.3390/medicina59030470.
: The purpose of this study was to evaluate the clinical outcomes in patients with primary open-angle glaucoma (POAG) and coexistent cataract treated with phacoemulsification cataract surgery, either alone or in combination with trabeculectomy. : Participants in this retrospective study were 52 patients diagnosed with previously controlled POAG and coexistent cataract, who underwent either uneventful phacoemulsification cataract surgery (Group I, n = 27) or combined uneventful phacoemulsification cataract surgery and trabeculectomy (Group II, n = 25), with at least a 24-month postoperative follow-up. We recorded the changes in intraocular pressure (IOP) and in the need of anti-glaucoma medications before and after surgical procedures. : There was a statistically significant decrease in IOP at postoperative day 7 in both groups ( < 0.001), which remained until the end of the 24-month follow-up. At month 24, the two groups did not differ significantly in terms of IOP (14.3 ± 1.4 vs. 13.1 ± 1.2 for Group I and Group II, respectively; = 0.447). In addition, there was a statistically significant decrease in the number of anti-glaucoma medications needed at postoperative day 7 in both groups ( < 0.001 for both groups compared to baseline). At month 24, patients in both groups needed about one additional anti-glaucoma medication to control their IOP. Of note, during the first month after surgery, 20% of patients in Group II needed 0.1 mL 5-FU injections to the bleb, although antimetabolites were not used in the primary surgery. : Both surgical interventions, namely phacoemulsification cataract surgery alone and phacoemulsification/trabeculectomy, were found to be effective in the management of POAG with coexistent cataract, presenting a significant decrease in IOP and in the need of anti-glaucoma medications postoperatively at a long-term follow-up period of 24 months.
: 本研究旨在评估原发性开角型青光眼（POAG）合并白内障患者接受超声乳化白内障吸除术（ECCE）单独或联合小梁切除术的临床效果。 : 本回顾性研究共纳入 52 例既往控制良好的 POAG 合并白内障患者，他们分别接受了单纯 ECCE（I 组，n = 27）或 ECCE 联合小梁切除术（II 组，n = 25），术后随访至少 24 个月。我们记录了手术前后眼压（IOP）和抗青光眼药物需求的变化。 : 两组患者术后第 7 天 IOP 均有显著下降（< 0.001），且持续至术后 24 个月。术后 24 个月，两组患者 IOP 无显著差异（I 组和 II 组分别为 14.3 ± 1.4mmHg 和 13.1 ± 1.2mmHg； = 0.447）。此外，两组患者术后第 7 天所需抗青光眼药物数量均显著减少（与基线相比，两组均 < 0.001）。术后 24 个月，两组患者均需增加 1 种左右的抗青光眼药物来控制眼压。值得注意的是，在术后第 1 个月，20%的 II 组患者需要向滤过泡内注射 0.1ml 5-FU，尽管初次手术未使用抗代谢药物。 : 单纯 ECCE 和 ECCE 联合小梁切除术对 POAG 合并白内障的治疗均有效，术后长期随访 24 个月，IOP 显著降低，抗青光眼药物需求减少。
