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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

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A Correction to this article was published on 21 February 2020

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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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Change history

  • 21 February 2020

    In the original publication, the corresponding author name was spelt incorrectly.

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Authors and Affiliations

  1. University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091, Zurich, Switzerland

    Lidija Jozic

  2. Department of Ophthalmology, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland

    Jens Funk & Marc Töteberg-Harms

  3. nordBLICK Praxis Pinneberg, Bismarckstraße 6, 25421, Pinneberg, Germany

    Lidija Jozic

  4. Qualitätsgemeinschaft Augenheilkunde Nord, Augentagesklinik Ballindamm, Ballindamm 37, 20095, Hamburg, Germany

    Joachim Magner

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  4. Marc Töteberg-Harms
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Contributions

LJ conducted the acquisition of the data, interpreted the data, drafted the manuscript, and gave final approval of the version for publication. JM performed the surgeries, revised the manuscript, and gave final approval of the version for publication. JF interpreted the data, revised the manuscript, and gave final approval of the version for publication. MTH designed the study, analyzed and interpreted the data, revised the manuscript, and gave final approval of the version for publication.

Corresponding author

Correspondence to Marc Töteberg-Harms.

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Conflict of interest

Author MTH is an advisor with Iridex and MLase. Furthermore, author MTH received speakers honorarium from Alcon/Novartis, Allergan, and Iridex.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The original version of this article was revised: The corresponding author name is corrected.

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Jozic, L., Magner, J., Funk, J. et al. Success of combined cataract extraction plus excimer laser trabeculotomy exceeds that of combined ab interno trabeculectomy with the trabectome or cataract extraction alone. Int Ophthalmol 40, 529–537 (2020). https://doi.org/10.1007/s10792-019-01191-9

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