Comparison of one-site versus two-site phacotrabeculectomy without the use of antimetabolites intraoperatively in patients with pseudoexfoliation glaucoma and primary open-angle glaucoma

Figures & data

Table 1 Intra- and postoperative complications in one-site and two-site phacotrabeculectomy

	POAG (50)		PEXG (50)
	One-site (1A)	Two-site (1B)	One-site (2A)	Two-site (2B)
Capsular rupture-AC IOL	1 (4%)	2 (8%)	2 (8%)	2 (8%)
Capsular rupture-PC IOL	2 (8.3%)	1 (4.3%)	2 (8.7%)	2 (8.7%)
Conjuctival bleb leaks Early (<7 days)	2 (8.3%)	3 (13%)	2 (8.7%)	3 (13%)
Grade 1 Spaeth shallow anterior chamber^	0	0	1 (4.3%)	1 (4.3%)
Grade 2 Spaeth shallow anterior chamber^	1 (4.2%)	1 (4.3%)	2 (8.7%)	1 (4.3%)
Choroidal effusion	1 (4%)	1 (4.3%)	1 (4.3%)	1 (4.3%)
5-FU	8 (33%)	7 (30%)	12 (52%)	11 (48%)
Bleb encapsulation	1 (4%)	1 (4.3%)	0	1 (4.3%)
N:YAG capsulotomy	6 (25%)	4 (17.4%)	7 (30.4%)	5 (21.7%)

Abbreviations: AC IOL, anterior chamber IOL; IOL, intraocular lens; PC IOL, posterior chamber IOL; PEXG, pseudoexfoliation glaucoma; POAG, primary open-angle glaucoma; 5-FU, 5-Fluorouracil.

Note: ^Spaeth grading of shallow anterior chamber.

Table 2 Baseline characteristics for groups treated with one-site or two-site phacotrabeculectomy

	POAG		PEXG		p
	One-site (1A)	Two-site (1B)	One-site (2A)	Two-site (2B)
No of patients-eyes	24	23	23	23
Mean age (years)	75.2 ± 4.6	76.3 ± 5.4	74.8 ± 5.3	74.9 ± 4.6	0.881
Range (years)	67–85	68–85	65–89	67–85
Males/Females	11/13	10/13	11/12	10/13	0.989*
Mean C/D ratio	0.66 ± 0.17	0.68 ± 0.15	0.66 ± 0.17	0.68 ± 0.16	0.892

Abbreviations: ANOVA, analysis of variance; C/D, cup/disc; PEXG, pseudoexfoliation glaucoma; POAG, primary open-angle glaucoma.

Notes: One way ANOVA was performed;

* Chi square test.

Table 3 Mean IOP, antiglaucoma medication, VA preoperatively and 36 months postoperatively

	POAG		PEXG		p
	One-site (1A)	Two-site (1B)	One-site (2A)	Two-site (2B)
IOP preop	22.72 ± 2.17 mmHg	21.36 ± 2.37 mmHg	22.96 ± 2.30 mmHg	22.92 ± 2.45 mmHg	0.823
IOP postop	15.04 ± 1.57 mmHg	15.04 ± 1.99 mmHg	15 ± 1.80 mmHg	15.32 ± 1.31 mmHg	0.902
AM preop	2.84 ± 0.69	2.72 ± 0.79	2.68 ± 0.69	2.80 ± 0.70	0.546
AM postop	0.68 ± 0.69	0.84 ± 0.75	0.96 ± 0.67	0.84 ± 0.62	0.553
VA preop	0.26 ± 0.16	0.26 ± 0.17	0.23 ± 0.14	0.25 ± 0.14	0.882
VA postop	0.60 ± 0.31	0.47 ± 0.28	0.56 ± 0.26	0.60 ± 0.25	0.265

Abbreviations: IOP preop, mean intraocular pressure preoperatively; IOP postop, mean intraocular pressure postoperatively; AM preop, mean antiglaucoma medication preoperatively; AM postop, mean antiglaucoma medication postoperatively; PEXG, pseudoexfoliation glaucoma; POAG, primary open-angle glaucoma; VA preop, mean visual acuity preoperatively; VA postop, mean visual acuity postoperatively.

Note: One way ANOVA was performed.

Figure 1a POAG group: Mean IOPs in the one-site and two-site phacotrabeculectomy groups at all time points.

Abbreviations: IOP, intraocular pressure; PEXG, pseudoexfoliation glaucoma; POAG, primary open-angle glaucoma.

Table 4 Mean IOP, number of antiglaucoma medications, VA preoperatively and 36 months postoperatively in the one-site and two-site phacotrabeculectomy in POAG and PEXG patients

	POAG				PEXG
	One-site (1A) p1		Two-site (1B) p2		One-site (2A) p3		Two-site (2B) p4
IOP preop	22.72 ± 2.17 mmHg	0.020	21.36 ± 2.37 mmHg	0.023	22.96 ± 2.30 mmHg	0.021	22.92 ± 2.45 mmHg	0.022
IOP postop	15.04 ± 1.57 mmHg		15.04 ± 1.99 mmHg		15 ± 1.80 mmHg		15.32 ± 1.31 mmHg
AM preop	2.84 ± 0.69	0.031	2.72 ± 0.79	0.032	2.68 ± 0.69	0.039	2.80 ± 0.70	0.031
AM postop	0.68 ± 0.69		0.84 ± 0.75		0.96 ± 0.67		0.84 ± 0.62
VA preop	0.26 0.16	0.001	0.26 0.17	0.003	0.23 0.14	0.001	0.25 0.14	0.001
VA postop	0.60 0.31		0.47 0.28		0.56 0.26		0.60 0.25

Abbreviations: IOP preop, mean intraocular pressure preoperatively; IOP postop, mean intraocular pressure postoperatively; AM preop, mean antiglaucoma medication preoperatively; AM postop, mean antiglaucoma medication postoperatively; PEXG, pseudoexfoliation glaucoma; POAG, primary open-angle glaucoma; VA preop, mean visual acuity preoperatively; VA postop, mean visual acuity postoperatively.

Notes: p1, (significance) comparison in the one-site-POAG group: IOP preop vs IOP postop, AM preop vs AM postop, VA preop vs VA postop; p2 (significance) comparison in the two-site POAG group: IOP preop vs IOP postop, AM preop vs AM postop, VA preop vs VA postop; p3 (significance) comparison in the one-site PEXG group: IOP preop vs IOP postop, AM preop vs AM postop, VA preop vs VA postop; p4 (significance) comparison in the two-site PEXG group: IOP preop vs IOP postop, AM preop vs AM postop, VA preop vs VA postop; Mann–Whitney test.

Table 5 Mean number of antiglaucoma medications in the one-site and two-site phacotrabeculectomy groups at all time points in POAG and PEXG patients

AM	POAG		PEXG		p
	One-site (1A)	Two-site (1B)	One-site (2A)	Two-site (2B)
Preop	2.84 ± 0.69	2.72 ± 0.80	2.68 ± 0.69	2.80 ± 0.70	0.856
One day postop	0	0	0	0
Seven days postop	0	0	0	0
One month postop	0	0.12 ± 0.33	0.20 ± 0.40	0.16 ± 0.37	0.387
Three months postop	0	0.16 ± 0.37	0. 16 ± 0.37	0.16 ± 0.37	0.973
Six months postop	0.36 ± 0.57	0.64 ± 0.63	0.40 ± 0.58	0.26 ± 0.37	0.051
Two years postop	0.64 ± 0.70	0.84 ± 0.80	0.88 ± 0.66	0.84 ± 0.55	0.601
Three years postop	0.68 ± 0.70	0.84 ± 0.75	0.96 ± 0.67	0.84 ± 0.62	0.553

Abbreviations: AM, antiglaucoma medication; ANOVA, analysis of variance; PEXG, pseudoexfoliation glaucoma; POAG, primary open-angle glaucoma; preop, preoperatively; postop, postoperatively.

Note: One way ANOVA was performed.

Figure 1b PEXG group: Mean IOPs in the one-site and two-site phacotrabeculectomy groups at all time points.

Abbreviations: IOP, intraocular pressure; PEXG, pseudoexfoliation glaucoma; POAG, primary open-angle glaucoma.

Figure 2a One-site phacotrabeculectomy. Mean IOPs in the PEXG and POAG groups at all time points.

Abbreviations: IOP, intraocular pressure; PEXG, pseudoexfoliation glaucoma; POAG, primary open-angle glaucoma.

Figure 2b Two-site phacotrabeculectomy. Mean IOPs in the PEXG and POAG groups at all time points.

Abbreviations: IOP, intraocular pressure; PEXG, pseudoexfoliation glaucoma; POAG, primary open-angle glaucoma.

Table 6 Eyes not requiring antiglaucoma medication by the end of the follow up (three years)

	POAG	PEXG	p
One-site phacotrabeculectomy	11/24 (45.8%)	6/23(26.1%)	0.159
Two-site phacotrabeculectomy	9/23 (39.1%)	7/23 (30.4%)	0.536
Total	20/47 (42.6%)	13/46 (28.3%)	0.150

Abbreviations: PEXG, pseudoexfoliation glaucoma; POAG, primary open-angle glaucoma.

Note: Chi square test was performed.