| Comparison of Filtering-Bleb Survival and Intraocular Pressure between Combined Phacotrabeculectomy and Trabeculectomy in Primary Glaucomas. |
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Dong Won Heo, Chang Sik Kim |
1Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea. kcs61@cnu.ac.kr
2Research Institute for Medical Science, Chungnam National University, Daejeon, Korea. |
| 원발녹내장에서 백내장초음파유화섬유주절제술과 섬유주절제술의 여과포와 안압의 경과비교 |
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허동원1⋅김창식1,2 |
Department of Ophthalmology, Chungnam National University College of Medicine1, Daejeon, Korea
Research Institute for Medical Science, Chungnam National University2, Daejeon, Korea |
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| Abstract |
PURPOSE
To evaluate clinical results of combined phacotrabeculectomy (PHACO-TRAB) and trabeculectomy (TRAB) for primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). METHODS: Forty-two eyes of 42 patients with POAG and 60 eyes of 60 patients with PACG were studied retrospectively. Fifty-two patients underwent PHACO-TRAB and 50 patients underwent TRAB. The IOP, number of anti-glaucoma medications, and duration of filtering bleb survival for 3 years after surgery were compared. RESULTS: For 12 months after surgery, the TRAB group maintained significantly lower IOP than the PHACO-TRAB group (p < 0.05, t-test), and there was no significant difference thereafter. The filtering bleb survival rate was significantly higher in the TRAB group during the study period. In patients with POAG, the TRAB group showed higher filtering bleb survival rate for 3 years (p = 0.016, log-rank test). However, in patients with PACG, there was no significant difference in filtering bleb survival between the 2 groups. In patients with POAG, the TRAB group maintained significantly lower IOP for 12 months after surgery, and there was no significant difference afterwards. In patients with PACG, the TRAB group maintained lower IOP only at 1, 3, and 6 months after surgery. However, the PHACO-TRAB group showed significantly lower IOP at 18 months and 36 months after surgery. CONCLUSIONS: In patients with POAG, TRAB was more effective in lowering IOP and maintaining filtering bleb. However in patients with PACG, there was no difference in filtering bleb survival between the 2 groups. TRAB was more effective in maintaining IOP during the early period after surgery, but PHACO-TRAB was superior to TRAB beyond 1 year after surgery in patients with PACG. |
| Key Words:
Filtering bleb;Intraocular pressure;Phacotrabeculectomy;Trabeculectomy |
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