Role of Phacoemulsification versus Phacotrabeculectomy on IOP in Patients with Primary Narrow Angle Glaucoma

Abstract
Background: Cataract surgery alone has gained more acceptance as an alternative surgical approach for primary angle closure glaucoma management. This view was supported by the recent advances in phacoemulsification and intraocular lenses, which possess a greater safety and a quicker visual recovery, in addition to a substantial reduction of intraocular pressure, deepening of the anterior chamber, and widening the filtration angle.
Aim of Study: The current study is to evaluate the effects of phacoemulsification and Intraocular Lens (IOL) implantation versus phacotrabeculectomy on IOP in eyes with PACG and coexisting cataract.
Patients and Methods: The current study is a randomized control study that has been conducted on 40 patients who were diagnosed to have PACG and chronic narrow angle glaucoma. Patients were recruited and followed in the Depart-ment of Ophthalmology, Mansoura University and were divided into 2 groups; (Group A) patients who underwent phacoemulsification and IOL implantation, and (Group B) patients who underwent phacotrabeculectomy and IOL im-plantation.
Results: The preoperative mean IOP ± SD for Group A was reduced from 24.76±9.87mmHg to a mean of 12.17±1.68, 11.88±1.32, 11.88±1.32, and 11.88±1.32 at 1 week, 1 month, 3 months, 6 months and 12 months respectively. A statistically significant reduction in the IOPs was recorded at all-time points (p-value <0.05). Similarly, the preoperative mean IOP ± SD for Group B was reduced from 24.56±7.19mmHg to a mean of 11.55±1.19, 11.28±1.04, 11.28±1.04, and 11.28±1.04 at 1 week, 1 month, 3 months, 6 months and 12 months respectively. A statistically significant reduction in the IOP were recorded at all time points (p-value <0.05).
Conclusion: The results are collected and statistically analyzed as well as published. We found that the phacoemul-sification with IOL implantation is associated with comparable results with the conventional surgery (phacoemulsification with IOL implantation and sub-scleral trabeculectomy) but the later is associated with higher incidence of complication.