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Success of combined cataract extraction plus excimer laser trabeculotomy exceeds that of combined ab interno trabeculectomy with the trabectome or cataract extraction alone


Jozic, Lidija; Magner, Joachim; Funk, Jens; Töteberg-Harms, Marc (2020). Success of combined cataract extraction plus excimer laser trabeculotomy exceeds that of combined ab interno trabeculectomy with the trabectome or cataract extraction alone. International Ophthalmology, 40(3):529-537.

Abstract

PURPOSE
To determine the efficacy of cataract surgery alone and combined with two minimally invasive glaucoma surgery (MIGS) procedures (phaco-ELT and phaco-aiT).

METHODS
Data was collected from 12/2007 to 02/2012 in this retrospective, non-randomized, comparative single surgery center study. Reduction in IOP and hypotensive medication (AGD), change in visual acuity, success rates, and complications were computed by comparing preoperative data with data at 1 year postoperatively.

RESULTS
A total of 245 eyes of 245 subjects were included. Study eyes underwent phaco alone (38 eye) or combined phaco-ELT (105 eye) and phaco-aiT (102 eye). Phaco alone, combined phaco-ELT, and combined phaco-aiT lowered IOP by 1.5 ± 4.0 mmHg, 4.3 ± 5.6, and 5.3 ± 4.5 mmHg, respectively (P < 0.01). Survival time of phaco-ELT outreached survival time of phaco alone and combined phaco-aiT (20.6 ± 1.0 vs. 13.2 ± 0.4 and 12.9 ± 0.6 month, respectively). No serious complications or adverse events occurred. None of the cases required a subsequent procedure within the first year to lower IOP further.

CONCLUSIONS
All three surgical procedures lowered IOP and reduced medication. However, the IOP-lowering efficacy of the two combined MIGS procedures exceeded the effect of phaco alone. A combined phaco and MIGS procedures seem reasonable to consider whenever a cataract surgery in an eye with glaucoma or ocular hypertension is considered. In addition, the combined MIGS procedure effectively lowers IOP whenever a target IOP in the mid-teens is sufficient. In this study, the nonthermal phaco-ELT procedure showed superior efficacy at 1 year over phaco alone and phaco-aiT in the Kaplan-Meier statistics.

Abstract

PURPOSE
To determine the efficacy of cataract surgery alone and combined with two minimally invasive glaucoma surgery (MIGS) procedures (phaco-ELT and phaco-aiT).

METHODS
Data was collected from 12/2007 to 02/2012 in this retrospective, non-randomized, comparative single surgery center study. Reduction in IOP and hypotensive medication (AGD), change in visual acuity, success rates, and complications were computed by comparing preoperative data with data at 1 year postoperatively.

RESULTS
A total of 245 eyes of 245 subjects were included. Study eyes underwent phaco alone (38 eye) or combined phaco-ELT (105 eye) and phaco-aiT (102 eye). Phaco alone, combined phaco-ELT, and combined phaco-aiT lowered IOP by 1.5 ± 4.0 mmHg, 4.3 ± 5.6, and 5.3 ± 4.5 mmHg, respectively (P < 0.01). Survival time of phaco-ELT outreached survival time of phaco alone and combined phaco-aiT (20.6 ± 1.0 vs. 13.2 ± 0.4 and 12.9 ± 0.6 month, respectively). No serious complications or adverse events occurred. None of the cases required a subsequent procedure within the first year to lower IOP further.

CONCLUSIONS
All three surgical procedures lowered IOP and reduced medication. However, the IOP-lowering efficacy of the two combined MIGS procedures exceeded the effect of phaco alone. A combined phaco and MIGS procedures seem reasonable to consider whenever a cataract surgery in an eye with glaucoma or ocular hypertension is considered. In addition, the combined MIGS procedure effectively lowers IOP whenever a target IOP in the mid-teens is sufficient. In this study, the nonthermal phaco-ELT procedure showed superior efficacy at 1 year over phaco alone and phaco-aiT in the Kaplan-Meier statistics.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Ophthalmology Clinic
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Ophthalmology
Language:English
Date:1 March 2020
Deposited On:17 Jan 2020 13:19
Last Modified:29 Jul 2020 12:51
Publisher:Springer
ISSN:0165-5701
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s10792-019-01191-9
Related URLs:https://www.zora.uzh.ch/id/eprint/184325/
PubMed ID:31724109

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