Intraocular pressure and visual results from combined surgery: phacoemulsification with non penetrating deep sclerectomy and phacoemulsification with trabeculectomy

Purpose: the aim of the present study is to compare the intraocular pressure (IOP) and visual acuity (VA) after combined surgery: phacoemulsification with non penetrating deep sclerectomy and phacoemulsification with trabeculectomy. Methods: this is an observacional and retrospective study by chart review. We selected 148 eyes from 127 patients from Tadeu Cvintal Ophthalmolgy Institute during January 1998 thru January 2007. All patients had primary angle glaucoma and cataract. Seventy seven patients were female, 49 (59%) had phacoemulsification with non penetrating deep sclerectomy and 28 (63,6%) had phacoemulsification with trabeculectomy. Fifty patients were male, 34 (41%) had phacoemulsification with non penetrating deep sclerectomy and 16 (36,4%) phacoemulsification with trabeculectomy. The patients had IOP (Goldmann) and VA (LogMar) measured before surgery and one year after surgery, also the number of glaucoma medications that patients had to drop after surgery. Results: the groups were equals comparing VA before (p = 0,067), and after VA (p = 0,924) with variation VA (p = 0,099). The mean VA in the group that had phacoemulsification with trabeculectomy was 0,31 (dp = 0,59) (p < 0,0001), and the mean variation in the group that had phacoemulsification with non penetrating deep sclerectomy was -0,45 (dp 0,51) with p, 0,001. The IOP mean variation in the patients that had phacoemulsification with non penetrating deep sclerectomy -6,2 (dp = 5,1) had stastistically difference (p < 0,001) and the mean variation of IOP in the patients that underwent phacoemulsification with trabeculectomy was -6,6 (dp = 5,3) (p < 0,001). There was no statistically difference between the groups evaluating the glaucoma medications. Conclusion: non penetrating deep sclerectomy combined with phacoemulsification causes IOP reduction similar phacoemulsification with trabeculectomy with the same result evaluating VA.