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One-site versus two-site phacotrabeculectomy: a prospective randomized study.

Moschos MM, Chatziralli IP, Tsatsos M - Clin Interv Aging (2015)

Bottom Line: Mean postoperative IOP significantly decreased in both groups compared to the preoperative level and was 15.6 mmHg (SD 3.5) in the one-site group and 14.9 mmHg (SD 2.7) in the two-site group.Both techniques yielded 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.

View Article: PubMed Central - PubMed

Affiliation: First Department of Ophthalmology, University of Athens, Athens, Greece.

ABSTRACT

Purpose: The purpose of this study is to compare the efficacy and safety of one-site and two-site combined phacotrabeculectomy with foldable posterior chamber intraocular lens implantation.

Methods: Thirty-four patients (41 eyes) with glaucoma and cataract were randomly assigned to undergo either a one-site (22 eyes) or a two-site (19 eyes) combined procedure. One-site approach consisted of a standard superior phacotrabeculectomy with a limbus-based conjunctival flap, while two-site approach consisted of a clear cornea phacoemulsification and a separate superior trabeculectomy with a limbus-based conjunctival flap.

Results: Mean follow-up period was 54 months (standard deviation [SD] 2.3). Mean preoperative intraocular pressure (IOP) in the one-site group was 21.3 mmHg (SD 2.8) and in the two-site group was 21.8 mmHg (SD 3.0) (P>0.1). Mean postoperative IOP significantly decreased in both groups compared to the preoperative level and was 15.6 mmHg (SD 3.5) in the one-site group and 14.9 mmHg (SD 2.7) in the two-site group. Three months later, the difference between the two groups was not statistically significant (P=0.058). The one-site group required significantly more medications than the two-site group (P=0.03). Best-corrected visual acuity (BCVA) improved similarly in both groups, but there was less postoperative (induced) astigmatism in the two-site group in a marginal statistical level (P=0.058). Intra- and postoperative complications were comparable in the two groups.

Conclusion: Both techniques yielded 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.

No MeSH data available.


Related in: MedlinePlus

Number of pre- and postoperative glaucoma medications for each eye, in the two-site group.
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f3-cia-10-1393: Number of pre- and postoperative glaucoma medications for each eye, in the two-site group.

Mentions: The number of glaucoma medications was reduced from 1.8 preoperatively to 0.6 postoperatively in the one-site group and from 2.1 preoperatively to 0.2 postoperatively in the two-site group. There is a statistically significant difference in favor of the two-site group in the number of glaucoma medications used postoperatively (P=0.03, Mann–Whitney–Wilcoxon test). No patient in the two-site group used more than one medication postoperatively in order to achieve adequate control of IOP. Three patients in the one-site group needed two glaucoma medications postoperatively. The percentage of patients who were on no medications postoperatively was lower in the two-site group (15; 78.95% of all patients in the group) compared to the one-site group (11; 50% of all patients in the group). All patients used fewer glaucoma medications after surgery. The number of glaucoma medications used pre- and postoperatively by patients in each of the two groups is illustrated in Figures 2 and 3.


One-site versus two-site phacotrabeculectomy: a prospective randomized study.

Moschos MM, Chatziralli IP, Tsatsos M - Clin Interv Aging (2015)

Number of pre- and postoperative glaucoma medications for each eye, in the two-site group.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554436&req=5

f3-cia-10-1393: Number of pre- and postoperative glaucoma medications for each eye, in the two-site group.
Mentions: The number of glaucoma medications was reduced from 1.8 preoperatively to 0.6 postoperatively in the one-site group and from 2.1 preoperatively to 0.2 postoperatively in the two-site group. There is a statistically significant difference in favor of the two-site group in the number of glaucoma medications used postoperatively (P=0.03, Mann–Whitney–Wilcoxon test). No patient in the two-site group used more than one medication postoperatively in order to achieve adequate control of IOP. Three patients in the one-site group needed two glaucoma medications postoperatively. The percentage of patients who were on no medications postoperatively was lower in the two-site group (15; 78.95% of all patients in the group) compared to the one-site group (11; 50% of all patients in the group). All patients used fewer glaucoma medications after surgery. The number of glaucoma medications used pre- and postoperatively by patients in each of the two groups is illustrated in Figures 2 and 3.

Bottom Line: Mean postoperative IOP significantly decreased in both groups compared to the preoperative level and was 15.6 mmHg (SD 3.5) in the one-site group and 14.9 mmHg (SD 2.7) in the two-site group.Both techniques yielded 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.

View Article: PubMed Central - PubMed

Affiliation: First Department of Ophthalmology, University of Athens, Athens, Greece.

ABSTRACT

Purpose: The purpose of this study is to compare the efficacy and safety of one-site and two-site combined phacotrabeculectomy with foldable posterior chamber intraocular lens implantation.

Methods: Thirty-four patients (41 eyes) with glaucoma and cataract were randomly assigned to undergo either a one-site (22 eyes) or a two-site (19 eyes) combined procedure. One-site approach consisted of a standard superior phacotrabeculectomy with a limbus-based conjunctival flap, while two-site approach consisted of a clear cornea phacoemulsification and a separate superior trabeculectomy with a limbus-based conjunctival flap.

Results: Mean follow-up period was 54 months (standard deviation [SD] 2.3). Mean preoperative intraocular pressure (IOP) in the one-site group was 21.3 mmHg (SD 2.8) and in the two-site group was 21.8 mmHg (SD 3.0) (P>0.1). Mean postoperative IOP significantly decreased in both groups compared to the preoperative level and was 15.6 mmHg (SD 3.5) in the one-site group and 14.9 mmHg (SD 2.7) in the two-site group. Three months later, the difference between the two groups was not statistically significant (P=0.058). The one-site group required significantly more medications than the two-site group (P=0.03). Best-corrected visual acuity (BCVA) improved similarly in both groups, but there was less postoperative (induced) astigmatism in the two-site group in a marginal statistical level (P=0.058). Intra- and postoperative complications were comparable in the two groups.

Conclusion: Both techniques yielded 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.

No MeSH data available.


Related in: MedlinePlus