Comparison of one-site versus two-site phacotrabeculectomy without the use of antimetabolites intraoperatively in patients with pseudoexfoliation glaucoma and primary open-angle glaucoma

Eleni Bagli, Christos Gartzios, Ioannis Asproudis, Georgios Kitsos

University Eye Clinic of Ioannina, Ioannina, Greece

Purpose: The comparison of one-site versus two-site phacotrabeculectomy in patients with pseudoexfoliation glaucoma (PEXG) and primary open-angle glaucoma (POAG), with respect to intraocular pressure (IOP), antiglaucomatous medication (AM) requirements and visual acuity (VA).

Methods: Forty-seven patients (eyes) with cataract and POAG and 46 sex- and age-matched patients with cataract and PEXG were randomized to one- or two-site phacotrabeculectomy and reviewed with a follow-up at three years.

Results: Mean preoperative IOP was 22.04 ± 2.27 mmHg and 22.92 ± 2.35 mmHg in POAG and PEXG groups (p > 0.05) using a mean of 2.76 ± 0.74, 2.74 ± 0.69 AM, respectively (p > 0.05). After three years of follow-up, the mean IOP was 15.04 ± 1.57 mmHg in the one-site, 15.04 ± 1.99 mmHg in the two-site group with POAG, 15 ± 1.8 mmHg in the one-site, 15.32 ± 1.31 mmHg in the two-site group with PEXG, using a mean of 0.68 ± 0.69, 0.84 ± 0.75, 0.96 ± 0.67, and 0.8 ± 0.62 AM, respectively. Mean IOP and AM postoperatively were significantly less compared to preoperatively for each group (p < 0.05). No difference was observed in mean IOP and AM between the four groups at three years postoperatively (p > 0.05). VA improved similarly in four groups at the three-year follow-up (p < 0.05). Intraoperative, postoperative complications, and need for 5-fluorouracil injections were similar between the surgical groups.

Conclusion: One-site and two-site phacotrabeculectomy without the use of antimetabolites intraoperatively were similarly safe and effective in IOP control over a three-year follow-up period in patients with POAG and PEXG.

Keywords: phacotrabeculectomy, pseudoexfoliation, glaucoma