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Long-term treatment success and safety of combined phacoemulsification plus excimer laser trabeculostomy: an 8-year follow-up study

  • Glaucoma
  • Published:
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A Correction to this article was published on 11 March 2022

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Abstract

Purpose

Combined phacoemulsification plus excimer laser trabeculostomy (phaco-ELT) is a minimally invasive surgery that effectively reduces intraocular pressure (IOP) in patients with glaucoma and a concomitant diagnosis of cataract. The aim of this study was to evaluate the long-term treatment success as well as safety of phaco-ELT over an 8-year follow-up period.

Methods

Patients with a diagnosis of primary or secondary glaucoma or ocular hypertension and a visually significant cataract who underwent a combined phaco-ELT between January 1, 2008, and December 31, 2010, were included. Data for IOP, the number of IOP-lowering medications (meds), best-corrected visual acuity, complications, and subsequent surgeries to lower IOP were collected preoperatively (baseline) and intraoperatively as well as at 1 day, 1 week, 1 month, 3 months, 6 months, 9 months, 1 year, and every 6 months thereafter to 8 years postoperatively.

Results

One hundred sixty-one eyes of 128 patients were included. After 8 years of follow-up, the long-term treatment success rate with IOP ≤ 21 mmHg was 50.2%. No serious intra- or postoperative complications occurred. The mean IOP decreased significantly from 19.3 (±4.8) mmHg at baseline to 15.4 (±3.2, p =0.0040) mmHg at 8 years. Additionally, meds remained below baseline after 8 years of follow-up and were reduced significantly for up to 4 years. Only 25.5% of the eyes required a subsequent surgery to lower IOP during the follow-up period.

Conclusion

Combined phaco-ELT is a safe procedure without serious intra- or postoperative complications, which has a positive long-term effect regarding IOP and meds. Remarkably, the mean IOP-lowering effect remained stable and was reduced ≥ 20% from baseline after 3 months for the remainder of the follow-up duration, whereas the number of meds was reduced significantly for up to 4 years. Furthermore, only 25.5% of the eyes required a subsequent surgery to control IOP throughout the whole follow-up of 8 years.

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Data available on reasonable request.

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Acknowledgments

The authors thank Mr. David He, Analytical Solutions Group, Inc., North Potomac, MD, USA, for the statistical analysis.

Funding

ELT Sight, Los Angeles, CA, USA, provided funding for the statistical analysis and was not involved in the study design or writing of the manuscript.

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Authors and Affiliations

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

    Maik Riesen, Jens Funk & Marc Töteberg-Harms

  2. University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland

    Maik Riesen, Jens Funk & Marc Töteberg-Harms

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  1. Maik Riesen
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Correspondence to Marc Töteberg-Harms.

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Ethics approval

The study was approved by the local ethics committee (Cantonal Ethics Committee of the Canton of Zurich, Zurich, Switzerland, KEK-ZH-No. 2019-01002).

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Not applicable.

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Not applicable.

Conflicts of interest

MR, none. JF, none. MTH, Allergan/Abbvie, consultant/advisor, lecture fees; Eyelight, consultant/advisor; ELT Sight, consultant/advisor; Glaukos Corporation, lecture fees; Heidelberg Engineering, lecture fees; IRIDEX, consultant/advisor, lecture fees, travel reimbursement, research grant; MLase AG, consultant/advisor, lecture fees; Novartis, Alcon Pharmaceuticals, lecture fees; Reichert, consultant/advisor, lecture fees; Santen, Inc., consultant/advisor, lecture fees, research grant; Théa Pharma, lecture fees.

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The paper referenced as no. 44 was presented as a poster at the Annual Meeting of the American Glaucoma Society, which took place in Coronado, CA, USA on March 2–5, 2017.

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Riesen, M., Funk, J. & Töteberg-Harms, M. Long-term treatment success and safety of combined phacoemulsification plus excimer laser trabeculostomy: an 8-year follow-up study. Graefes Arch Clin Exp Ophthalmol 260, 1611–1621 (2022). https://doi.org/10.1007/s00417-021-05510-8

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