Study finds 5-year Outcomes between- Trabeculectomy combined
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Researchers aimed to compare the outcomes of trabeculectomy combined with phacoemulsification and those of trabeculectomy followed by phacoemulsification.

A total of 141 patients with primary open-angle glaucoma, exfoliation glaucoma, and glaucoma secondary to uveitis glaucoma who underwent trabeculectomy followed by (n=48) or combined with (n=93) phacoemulsification were included. A prospective cohort study conducted in 34 clinical centers that included 1249 eyes was analyzed.

The main outcome was the cumulative probability of success based on intraocular pressure (IOP) within 5years. Surgical failure was defined as a case in which additional glaucoma surgery is required or one of the following criteria are met: preoperative IOP more than 21 (A) more than 18 (B), or more than 15 mmHg (C).

Results:
--No significant difference was found in the cumulative probability of success as the main outcome.

--When the data on phacoemulsification during the 5-year follow-up were censored, the probabilities of success of trabeculectomy followed by phacoemulsification were significantly higher for criteria A, B, and C.

--Lower preoperative IOP, younger age, and trabeculectomy combined with phacoemulsification were associated with poorer outcome.

--Trabeculectomy followed by phacoemulsification had significantly worse delta logMAR visual acuity at 6 and 12 months.

Finally, after trabeculectomy combined with or accompanied by phacoemulsification, the accumulated likelihood of success remained unchanged. The cumulative likelihood of success after trabeculectomy was lowered when phacoemulsification and trabeculectomy were combined. After combining phacoemulsification and trabeculectomy, the visual acuity gains seen in the early postoperative period vanished after 5 years.

Source: https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-021-01949-9
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