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Comparison of long-term results of trabeculectomy and phacotrabeculectomy in patients with pseudoexfoliation glaucoma and primary open-angle glaucoma: a single-center study

Abstract

Purpose

To evaluate long-term surgical success and complications in pseudoexfoliation glaucoma (PEXG) and primary open-angle glaucoma (POAG) after trabeculectomy or phacotrabeculectomy.

Methods

96 PEXG eyes and 114 POAG eyes who underwent primary trabeculectomy and phacotrabeculectomy were retrospectively evaluated considering intraocular pressure (IOP), the number of glaucoma medications, surgical success, and rate of complications. Two success criteria were used: Complete success comprised IOP of 5–18 mmHg and 20% reduction of baseline IOP without medication. Qualified success comprised IOP of 5–18 mmHg and 20% reduction of baseline IOP irrespective of medication. Success rates in PEXG and POAG groups, trabeculectomy and phacotrabeculectomy groups, and four groups divided according to surgery and etiology were analyzed via Kaplan–Meier survival analysis.

Results

The complete and qualified success were not different between PEXG and POAG groups. The qualified success curves show a similar pattern among the four groups throughout the follow-up of 1,2,3,5,7 and 9 years. Baseline IOP and the number of medications were similar in all four groups (p = 0.275 and p = 0.209, respectively). IOP levels and the number of medications were not statistically different between the four groups during the follow-up of 2,5 and 7 years. The total number of complications and interventions were similar between PEXG and POAG groups (p = 0.258).

Conclusions

Phacotrabeculectomy is an effective procedure as trabeculectomy with similar surgical success rates and few surgical complications when it comes to treating PAOG and PEXG patients. Both approaches resulted in similar postoperative IOP levels and medication numbers in both groups.

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Data availability

Data available on request.

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Funding

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Authors

Contributions

BYT, NY, and EK involved in conceptualization; BYT, NY, and SS involved in methodology; BYT and EK involved in formal analysis and investigation; BYT involved in writing—original draft preparation; BYT, NY, EK, and SS involved in writing—review and editing; BYT and NY involved in supervision. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Büşra Yilmaz Tugan.

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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 (KÜ-GOKAEK Project No: 2020/273) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Yilmaz Tugan, B., Yuksel, N., Kesim, E. et al. Comparison of long-term results of trabeculectomy and phacotrabeculectomy in patients with pseudoexfoliation glaucoma and primary open-angle glaucoma: a single-center study. Int Ophthalmol 42, 1737–1747 (2022). https://doi.org/10.1007/s10792-021-02169-2

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Keywords

  • Trabeculectomy
  • Phacotrabeculectomy
  • Primary open-angle glaucoma
  • Pseudoexfoliation glaucoma
  • Combined surgery