Purpose:- To compare one-site versus two-site phacotrabeculectomy in
patients with visually significant cataract and primary open-angle glaucoma
(POAG), with regard to achieve target intraocular pressure (IOP) and best
visual acuity (VA).
Method:- Forty patients (40 eyes) with coexistance glaucoma and cataract
were randomly assigned to undergo either a one-site (20 eyes) or a two-site
(20 eyes) phacotrabeculoectomy. One-site approach consisted of a standard
superior phacotrabeculectomy , while two-site approach consisted of a clear
cornea phacoemulsification and a separate superior trabeculectomy.
Results:- Mean preoperative intraocular pressure (IOP) in the one-site group
was 22.05 mmHg (SD 1.6) and in the two-site group was 22.4 mmHg (SD
1.8) (P 0.4) using a mean of 2.6 (SD 0.5), 2.7(SD 0.4) antiglaucomatus
medication (AM), respectively (p 0.56). Aftesr thirty months of follow-up,
the. Mean postoperative IOP significantly decreased in both groups
compared to the preoperative level and was 14.2 mmHg (SD 1.06) in the
one-site group and 13.5 mmHg (SD 1.19) in the two-site group (p 0.07) ,
using a mean of 0.3 (SD 0.47), and 0.25 (SD 0.44) A M, respectively. Mean
IOP and AM postoperatively were significantly less compared to
preoperatively for each group (p < 0.05).AS regard postoperative IOP, the
two sites has more reduction of IOP than one site bu not statistically
significant difference (p 0.07). AS regard postoperative AM two sites has
less AM than one site to control IOP , but not statistically significant
difference(p 0.94) . AS regard postoperative best-corrected visual acuity
(BCVA), the two site had better (BCVA) than the one site, but the difference
was not statistically significant (P 0.97). There was less postoperative
(induced) astigmatism in the two-site group and the difference was
statistically significant ((p 0.01).
Conclusion:- Both one-site and two-site phacotrabeculectomy had similar
results concerning final BCVA and IOP reduction. However, the two-site
group had less induced astigmatism and a better postoperative IOP control
with less required postoperative antiglaucoma medications compared to the
one-site group.
|
