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 sale and effective. However; the phaco-trab procedure may have slightly improved IOP control, earlier visual recovery and less astigmatism.