Comparison of results and complications following combined ECCE-trabeculectomy versus small-incision-trabeculectomy and posterior chamber lens implantation.

PURPOSE

To compare the efficacy and complication rate of two standard cataract extraction techniques with different incision lengths when combined with trabeculectomy.

METHODS

54 eyes after combined ECCE, posterior chamber lens implantation and trabeculectomy (ECCE-group) are compared with 49 eyes following phacoemulsification, trabeculectomy and implantation of a folded flexible posterior chamber lens (small-incision group). Minimum follow-up was 24 months.

RESULTS

Glaucoma control was achieved in all eyes of both groups. There was a tendency towards a higher number of patients without therapy in the small-incision group (82% versus 65%, p = 0.07). Final mean IOP (14.2 +/- 3.0 mmHg versus 15.5 +/- 2.7 mmHg, p = 0.02) and mean therapy index (0.2 +/- 0.5 versus 0.4 +/- 0.6, p = 0.03) were significantly lower in the small-incision group. Postoperative complications such as severe fibrin effusion (41% versus 18%, p = 0.018), early postoperative IOP rises > 25 mmHg (18% versus 2%, p = 0.009), filtering bleb scarring (63% versus 8%, p < 0.0001) and the total number of complications (87% versus 63%, p = 0.006) were significantly higher in the ECCE-group.

CONCLUSION

With the decrease of the incision size necessary for the cataract extraction a reduction of postoperative complications and better functional results are achieved in combined cataract/glaucoma surgery.