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One- and two-site phacotrabeculectomy show similar IOP reductions at 2 years

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There appears to be no statistically significant difference in IOP between one- and two-site phacotrabeculectomy with 2 years of follow-up, a prospective, randomized, controlled study found.

"We did, however, find that one-site surgery took statistically significantly less time than two-site surgery and that one-site surgery resulted in statistically significantly less corneal endothelial loss at 3 and 12 months than two-site surgery," the study authors said in the July issue of Ophthalmology.

Yvonne M. Buys, MD, FRCSC, and colleagues at Toronto Western Hospital and the University of Toronto randomly assigned 79 eyes of 79 patients to receive either one- or two-site phacotrabeculectomy and evaluated for IOP differences between the groups over 24 months of follow-up. Specifically, 39 eyes received one-site phacotrabeculectomy and 40 eyes received the two-site procedure. Of the 79 eyes, 76 eyes completed 24-month follow-up.

The investigators recorded demographics, visual acuity, IOP, endothelial cell counts, glaucoma medications, phacoemulsification settings, iris manipulation, suture lysis, needling and complications at 3, 6, 12 and 24 months.

At baseline, there were no significant differences between the groups, the authors noted.

There was a significant lowering of IOP compared with baseline at all time points (P < .05); however, the investigators found no significant difference in mean IOP between the groups at any time during follow-up.

At final follow-up, the mean number of glaucoma medications had decreased from three in each group to 0.2 and 0.4 in the one- and two-site groups, respectively (P = .20).

While both groups experienced a decrease in endothelial cell counts, the endothelial cell counts were significantly lower in the two-site group at 3 months (P = .01) and at 12 months (P = .04), the authors noted.

In addition, the surgical time was significantly longer for the two-site group (48.1 minutes) compared with the one-site group (39.2 minutes; P < .001), according to the study.