The Efficacy And Safety Of Combined Phacoemulsification And Trabeculectomy In Late Advanced Stage Of Primary Glaucoma : A 12 Months Follow Up

Published 2022 - 40th Congress of the ESCRS

Reference: PE016 | Type: ESONT - Abstract | DOI: 10.82333/nz1x-ns12

Authors: Widya Artini Wiyogo*, Zeiras Eka Djamal ¹ , Muhammad Yoserizal ¹ , Iwan Soebijantoro ¹

¹Glaucoma,JEC Eye Hospital and Clinics,Jakarta,Indonesia

Purpose

To evaluate the efficacy and safety, described in intraocular pressure (IOP) and vision-threatening complication, respectively, after combined phacoemulsification and ab interno trabeculectomy in adults with late-advanced stage primary glaucoma in Indonesia.

Setting/Venue

Adults with late-advanced stage primary glaucoma at JEC Eye Hospitals and Clinic in Jakarta, Indonesia were selected by reviewing medical records.

Methods

The medical records of selected patients were retrospectively reviewed. Data collection included IOP, visual acuity, visual field, optic disc ratio, retinal nerve fiber layer thickness, and IOP lowering medication used preoperatively and through up to 12 months post operatively. Complications, if any, were also noted. Paired T test and Wilcoxon tests were utilized to analyze the result.

Results

Data from 47 eyes of 40 subjects were analyzed. Majority of the subjects were male and most had POAG compared to PACG (62.5% vs 37.5%).

The mean visual field deviation (dB) was -22.68 ± 6.90 at baseline and -23.31 ± 7.04 post operatively. Mean IOP (mmHg) was 29.08 ± 11.39 at baseline and 15.11 ± 6.40 after mean follow up of 12 months. IOP reduction of ≥ 20% was achieved in 41/47 eyes (87.2%) with mean IOP reduction of 43%. Mean IOP lowering medication reduction of 60% was achieved and 16/47 eyes (34%) were medication-free at last follow-up. No vision-threatening complications were observed.

Conclusions

Combined phacoemulsification and ab interno trabeculectomy is a safe procedure to perform in late-advanced stage of primary glaucoma. This procedure provides statistically and clinically significant reduction of IOP and medication use with no wipe-out complication has been reported.