Simultaneous cataract and glaucoma surgery. Trabeculectomy site selection

Introduction
Analysis of the results of simultaneous surgery using phacotrabeculectomy technique and standard phacoemulsyfication and trabeculectomy from two separate incisions.

Material and methods
Analyzed group included 41 patients /44 eyes/, aged 68 ±18 years with combined glaucoma and cataract. In 28 operated eyeballs phacotrabeculectomy from single incision was performed and in 19 operated eyeballs phacotrabeculectomy and phacoemulsification from two separate incisions was used.

Results
In both analyzed groups authors obtained reduction in intraocular pressure and transparent optical system. In group of patients operated on from two separate incisions three times more often anterior chamber had become shallower with conjoined choroidal detachment and two times more often hypotension below 10 mmHg and breakdown of blood - aqueous fluid barrier were observed. Blood in anterior chamber was observed in 1/5 of operated patients with equal frequency in both analyzed groups. In addition in three months follow-up patients from two separate incisions presented more elevated intraocular pressure and more often required additional pharmacological therapy.

Conclusions
Simultaneous cataract and glaucoma surgery effectively reduces elevated intraocular pressure and improves transparency of optical system. Phacotrabeculectomy is safer and gives fewer complications than standard operation from two separate incisions.