Background
This study was conducted to evaluate the rate of intraoperative and postoperative complications and the outcome of combined
phacoemulsification (phaco) with posterior chamber (PC) intraocular lens (IOL) and trabeculectomy in patients with pseudoexfoliation
(PXF) versus non-pseudoexfoliation (non-PXF) glaucoma.
Methods
One hundred and four eyes of 88 patients with combined phaco, PC IOL and trabeculectomy with mitomycin C (MMC) were included
in the study. MMC 0.02% was applied for 1 min in all cases. Main outcome measures were rate of intraoperative and postoperative
complications, intraocular pressure (IOP) and visual acuity (VA). Success rates were determined via Kaplan–Meier survival
analysis. Surgical success for both groups was defined as IOP being less than 21 mmHg with no treatment or less than 16 with
one topical pressure-reducing agent allowed.
Results
The PXF group included 55 (52.9%) eyes and the non-PXF group 49 (47.1%) eyes. Transition to extracapsular cataract extraction
(ECCE) occurred in 12.7% of the PXF group, and in 6.1% of the non-PXF group (P=0.16). The occurrence of vitreous loss did not differ significantly between the groups. Patients of both groups had a significant
IOP reduction after surgery (P=0.0001). At the end of postoperative follow-up, the success rate approached 83.6% in the PXF group and 83.7% in the non-PXF
group. The most common postoperative complications were hyphema (14.5%) in the PXF group and fibrin (14.3%) in the non-PXF
group.
Conclusions
Although transition to ECCE was more frequent in the PXF than in the non-PXF group, there was no significant difference in
the rate of complications between PXF and non-PXF eyes.
Keywords Combined phacoemulsification and trabeculectomy - Pseudoexfoliation glaucoma - Mitomycin C
The Department of Ophthalmology, Kaplan Medical Center, Rehovot is affiliated to the School of Medicine, Hebrew University
and Hadassah, Jerusalem, Israel.