Posoperative complications of phacoemulsification associated with modified gonio-assisted trabeculectomy with scissors

Abstract

Objective: To evaluate the safety of phacoemulsification associated with modified gonio-assisted trabeculectomy with scissors.

Methods: Experimental intervention study in 103 eyes (103 patients) with primary open-angle glaucoma. Phacoemulsification and modified gonioassisted trabeculectomy with scissors (51 eyes, cases) and standard phacoemulsification-trabeculectomy (52 eyes, controls) were performed. In the cases, scissors and vitreoretinal forceps were required and trabeculum was resected by internal approach. Visual acuity, induced astigmatism, loss of endothelial cells and the appearance of surgical complications were evaluated in both groups at three months postoperative follow-up.

Results: The uncorrected visual acuity increased at three postoperative months in both groups, however it was higher for the PHACO-TGAM (0.81±0.16 vs 0.71±0.16); with significant differences (p=0.002). Induced astigmatism was significantly higher in the control group (0.53±1.14D vs. 1.8±1.20D, (p<0.001). Postoperative surgical complications were more frequent in the control group (57% vs 73%, p= 0.14), the endothelial cell loss did not show significant differences (p=0.82).

Conclusions: the visual recovery and the lower number of complications place phacoemulsification and modified gonio-assisted trabeculectomy with scissors as the technique of choice for the treatment of patients with cataract and primary open-angle glaucoma.