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ORIGINAL ARTICLE
Year : 2014  |  Volume : 2  |  Issue : 2  |  Page : 93-98

Comparison of phacoemulsification versus phacotrabeculectomy in the treatment of patients with chronic angle closure glaucoma and concomitant cataract


1 Regional Institute of Ophthalmology, Kolkata, West Bengal, India
2 B. B. Eye Foundation, Kolkata, West Bengal, India

Correspondence Address:
Chandrima Paul
B. B. Eye Foundation, 2/5, Sarat Bose Road, Sukhsagar, Kolkata - 700 020, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2320-3897.130538

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Aims: Whether phacoemulsification or phacotrabeculectomy (with adjunctive mitomycin C) is the surgery of choice in eyes with chronic angle closure glaucoma (CACG) with concomitant cataract. Settings and Design: Prospective comparative case series. Materials and Methods: Patients with CACG and cataract were randomized into two groups, comparing phacoemulsification (Group A) versus combined phacotrabeculectomy with mitomycin C (Group B). Group A had 60 eyes of medically controlled CACG with cataract and 58 eyes of medically uncontrolled CACG with cataract. Group B had 53 eyes of medically controlled CACG with cataract and 61 eyes of medically uncontrolled CACG with cataract. The two groups had identical study designs. All patients were reviewed 3-monthly for 2 years after surgery. The primary outcome measure was to compare the surgical complications of phacoemulsification versus phacotrabeculectomy and the secondary outcome measures were intraocular pressure (IOP) control and disease progression in the two groups. Statistical analysis used: Fisher's exact test and chi-square test. Results: There was no statistically significant difference in IOP control, glaucomatous progression, or final visual acuity, during the 24-month follow-up, between two groups. In Group A, 5 (4.2%) of 118 eyes reported four surgical complications while in Group B, 18 (15.8%) of 114 eyes had 16 surgical complications. The difference in the proportion of eyes with one or more surgical complications between the two groups was statistically significant [P = 0.003, 95% confidence interval (CI)*]. In addition to this the risk of surgical complication with phacotrabeculectomy was significantly higher when compared to phacoemulsification [3.73 (P = 0.003, 95% CI, 1.43-9.70)]*. Conclusions: Postsurgical complications were more frequently seen after phacotrabeculectomy. However, the data did not reveal statistically significant differences in IOP control, visual acuity, or disease progression between both groups.


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