Comparison of extracapsular and phaco‐emulsification cataract extraction techniques when combined with intra‐ocular lens placement and trabeculectomy: Short‐term results

Background Methods: Fifty patients who had undergone combined extracapsular cataract extraction (ECCE), intraocular lens (IOL) placement and trabeculectomy (ECCE‐trab) and 50 who had undergone combined cataract phaco‐emulsification, IOL placement and trabeculectomy (phaco‐trab) were reviewed over a period of 12 months. Results: Postoperatively, intra‐ocular pressure (IOP) in both eyes fell significantly ( P < 0.005). Initially, IOP fell to roughly equal degrees (mean IOP being 14 mmHg at 3 months; P = 0.84). At 12 months, IOP in the phacotrab group was slightly lower than that in the ECCE‐trab group (13.4 ± 4.3 vs 15.4 ± 4.4 mmHg, respectively; P = 0.0312). The number of pre‐operative medications did not appear to affect outcome ( P = 0.124).Visual recovery was approximately 3 months faster in the phaco‐trab group. By 12 months there was little difference in visual acuity, with an average improvement of two Snellen lines ( P = 0.68). The mean change in astigmatism was significantly less in the phacotrab group (0.61 ± 1.25 vs 1.39 ± 1.46 D, respectively, P = 0.0063). Transient hypotony (IOP < 5 mmHg) was more frequent in the phaco‐trab group (66 vs 32%, respectively; P < 0.002). The frequency of other complications was not significantly different between the two groups. Conclusion: Both ECCE‐trab and phaco‐trab procedures are safe and effective. However; the phaco‐trab procedure may have slightly improved IOP control, earlier visual recovery and less astigmatism.