Long-term results of combined surgery in patients with cataract and glaucoma

Aim – to evaluate the efficacy and safety of femto laser assisted phacoemulsification in coexistent cataract and glaucoma in combination with non-penetrating deep sclerectomy (NPDS) in long-term follow-up. Material and methods. The results of surgical treatment of concurrent cataract and glaucoma were analyzed retrospectively. The patients were divided into groups according to the method of surgical intervention: group 1 – phacoemulsification with NPDS and implantation of the Xenoplast drainage (49 eyes, 43 patients); group 2 – femto laser assisted phacoemulsification with NPDS and Xenoplast drainage implantation (27 eyes, 23 patients). Results. Before surgery, the average values of corneal-compensated intraocular pressure (IOP cc), pressure equated to Goldman pressure (IOP g) and corneal hysteresis (CH) in group 1 were 27.9±9.9 mm Hg, 27.7±8.9 mm Hg, 7.0±3.0 mm Hg.; in group 2 – 25.9±8.4 mm Hg, 24.7±7.7 mm Hg, 7.7±2.1 mm Hg, respectively. Five years after the surgical treatment, the average values of IOP cc, IOP g and CH in the 1st group were 17.1±3.8 mm Hg, 14.5±2.8 mm Hg, 8.5±2.6 mm Hg; in the 2nd group – 15.1±3.3 mm Hg, 15.3±4.7 mm Hg, 8.3±1.0 mm Hg, respectively. Normalization of IOP parameters and biomechanical properties of the corneoscleral membrane was noted in both groups, which persisted throughout the entire period of observation in the long-term postoperative period. Conclusion. Combined phacoemulsification with femto laser assistance and non NPDS with Xenoplast drainage implantation is an effective and safe way to improve visual functions and normalize IOP with subsequent stabilization of the glaucoma process in the late postoperative period.