Trabeculotomy Combined with Cataract Surgery in Glaucoma: Outcome in a Rural Setting

Purpose: Intensive postoperative care is essential for the outcome of trabeculectomy. However, in a rural setting, repeated visits to the operating theatre are often not requested or possible. The objective of this study was to examine the outcome of trabeculotomy combined with cataract surgery in patients with glaucoma. Patients and Methods: 142 patients with glaucoma and cataract were included in a retrospective clinical study. All patients were operated on from November 2005 to December 2008 by a single surgeon and with a minimum follow-up of 2 months. Intraocular pressure (IOP), number of antiglaucomatous medications and surgical success rate were assessed at 2 months and at the longest follow-up (at least 1 year). Results: IOP was significantly reduced from 24.1 +/- 8.3 mmHg preoperatively to 14.9 +/- 3.3mmHg at 2 months (p < 0.0001) and to 15.1 +/- 3mmHg at the longest follow-up (3.71 +/- 1.5 years). The number of IOP-lowering medications was lowered from 1.35 +/- 1 preoperatively to 0.73 +/- 1 at the longest follow-up. Complete surgical success (no IOP-lowering medications, longest follow-up) was achieved in 51.3% (IOP < 22mmHg) and 47.5% (IOP < 19mmHg) of patients, respectively. Conclusions: Trabeculotomy combined with cataract surgery is a safe and effective surgical option to treat combined cataract and glaucoma without the need of intensified postoperative treatment.