Combined Phacoendoscopic Cyclophotocoagulation versus Combined Phacotrabeculectomy in the Management of Coexisting Cataract and Glaucoma: A Comparative Study

Purpose. To compare the surgical outcome of combined phacoemulsification and endoscopic cyclophotocoagulation (phacoECP) versus combined phacoemulsification and mitomycin C-augmented trabeculectomy (phacoTbx) in patients with coexisting glaucoma and visually significant cataract. Methods. A retrospective review of 89 eyes of 89 patients who received phacoECP (N=49) and phacoTbx (N=40) was carried out at a tertiary eye center in Hong Kong. The minimum follow-up period was 6 months. Criterion of success was reduction of IOP at least 30% or absolute IOP of 15 mmHg or below without (complete success) or with (qualified success) antiglaucomatous medication. Results. PhacoTbx had more reduction of antiglaucomatous medication (4 vs 1, P<0.001). At postoperative year one, there was more IOP reduction for phacoTbx than phacoECP (8 mmHg vs 3 mmHg, P=0.012). The one-year complete success rate was also higher for phacoTbx (46.2% vs 8.2%, P<0.001), while qualified success was comparable between the 2 groups (74.4% vs 73.5%, P=0.925). Operation time was shorter for phacoECP (37 vs 73 minutes, P<0.001). The number of postoperative follow-up visits was less (6 vs 11.5, P<0.001) for phacoECP. Additional surgical procedures were more common in phacoTbx (55% vs 0%, P