Trabeculotomy Combination Procedure Effective in Cataract–Glaucoma Surgery


Peruvian researchers led by Juan Carlos Izquierdo, MD, conducted a comparative, nonrandomized retrospective study to evaluate and compare the 12-month efficacy and safety of combined phacoemulsification and endocyclophotocoagulation (ECP) with (group 1) and without (group 2) ab interno trabeculotomy in patients with uncontrolled open-angle glaucoma (OAG). The primary outcome was mean preoperative and postoperative IOP; the secondary outcomes included the reduction in number of glaucoma medications, visual acuity, reported complete, qualified success or failure, and complications.

Forty-six eyes of 36 patients were included; IOP was 16.96 mmHg ± 3.66 mmHg and 15.64 mmHg ± 4.88 mmHg for group 1 and group 2 respectively at baseline, and 11.44 mmHg ± 2.15 mmHg and 12.45 mmHg ± 1.90 mmHg, respectively, at the 12-month follow-up. The complete success rate was 56% in group 1 and 55% in group 2; the qualified success was 93% and 91%, respectively. Medications decreased from 2.0±1.4 to 0.8±1.0 in group 1 and from 1.5±1.3 to 1.0±1.5 in group 2. There was similar improvement in visual acuity in both groups. Complications were mild and resolved without intervention.

The researchers, who presented their findings at the 2020 ASCRS Virtual Annual Meeting, concluded that both procedures achieved efficient and safe reduction in IOP as observed in patients with uncontrolled OAG at 12-month follow-up. When ab interno trabeculotomy is added to phacoemulsification and ECP, the mean IOP is more greatly reduced, and this difference between the interventions is clinically significant.