A comparative study of complications and its management following phaco- trabeculectomy in primary open angle glaucoma, primary angle closure glaucoma and pseudo-exfoliative glaucoma with cataract

Introduction: Glaucoma is a progressive optic neuropathy with characteristic optic disc and visual field changes. Major types include primary open angle and primary closed angle glaucoma. Cataract is a progressive degeneration of crystalline lens resulting in its opacification. Incidence of concurrent cataract and glaucoma is increasing. Combined cataract and glaucoma surgery i.e Phacotrabeculectomy can be considered in these cases. Intraoperative and postoperative complications are known in combined surgeries. Comparision of complications and its management in 3 different types of glaucoma undergoing phacotrabeculectomy will be done. Materials and Methods: In this study, 90 eyes with cataract were divided into three groups, group A with POAG, group B with PACG, and group C with PXFG. All patients underwent phacotrabeculectomy by a single surgeon. Intraoperative and post-operative complications at 1 day, 1 week, 1 month, 3 months and 6 months were documented. Management of the complications were also noted. Results: No significant difference was seen in the three groups with respect to complications except at 1 month when high IOP was noted in POAG and PACG, which was statistically significant (p <0> All these cases underwent Argon suturolysis. One case of bleb failure due to late fibrosis was noted each in angle closure and pseudo-exfoliation group at 6 months follow up, which was not statistically significant. Conclusion: No significant difference was noted in the rate of intraoperative and post-operative complications between 3 types of glaucoma following pahcotrabeculectomy. This study shows that phacotrabeculectomy might be used as safe surgery in patients having co-existent cataract and glaucoma.