Combined phaco-trabeculotomy, deep sclerectomy lowered IOP in pilot study

Combining phaco-trabeculotomy with deep sclerectomy can significantly reduce IOP in eyes with uncontrolled open-angle glaucoma and may offer a success rate comparable to phaco-trabeculectomy, a pilot study suggests.

Christoph Lüke, MD, of the University of Cologne, Germany, and colleagues prospectively evaluated outcomes for 15 consecutive patients treated with the combined procedure. They found that mean IOP was significantly reduced to 14.2 mm Hg at 1 day postop. At 12 months follow-up, 60% of patients maintained an IOP less than 22 mm Hg without requiring glaucoma medications, according to the study.

Also at 12 months, visual acuity had significantly improved an average of 1.6 lines over baseline, the authors said.

Specific intra- and postoperative complications related to both deep sclerectomy and trabeculotomy were seen. However, the rate of complications due to overfiltration was low, they noted.

Investigators reported a 53% incidence of hyphema, but no patients experienced severe complications, such as bleb infection, endophthalmitis or choroidal hemorrhage, according to the study.

"Prospective comparative trials are needed to assess which of [phaco-trabeculectomy] and phaco-trabeculotomy plus deep sclerectomy is more successful," the authors said.

The study is published in the March issue of Acta Ophthalmologica Scandinavica.