Propective intrapatient comparion of extracapular cataract extraction and len implantation with and without trabeculectomy

PURPOE: To determine whether extracapular cataract extraction and poterior chamber len implantation combined with trabeculectomy provide better long-term reult than extracapular cataract extraction and len implantation alone in a group of patient with primary open-angle glaucoma and cataract. METHOD: In a propective, randomized clinical trial, 35 patient with bilateral, ymmetric, primary open-angle glaucoma and viually diabling cataract were randomly elected to undergo urgery with trabeculectomy in one eye and without in the other. All procedure were performed by a ingle urgeon in a private practice etting with follow-up for more than 5 year in all cae. REULT: After an average of 87 month of follow-up, extracapular cataract extraction and poterior chamber len implantation reduced intraocular preure by 4.4 ± 3.3 mm Hg, reduced the number of medication by 1.28 ± 0.86, increaed diopter vector of atigmatim by 1.49, and wa aociated with viual field lo in ix of 35 eye. After an average of 80 month of follow-up, extracapular cataract extraction and poterior chamber len implantation with trabeculectomy reduced intraocular preure by 8.2 ± 4.6 mm Hg (P = .0001), reduced the number of medication by 1.76 ± 0.82 (P= .0002), increaed diopter vector of atigmatim by 1.14, and wa aociated with viual field lo in one eye (P = .05). Both group had imilar improvement in viual acuity and perioperative complication. CONCLUION: Extracapular cataract extraction and poterior chamber len implantation with trabeculectomy wa beneficial in the long-term control of intraocular preure and in prevention of viual field lo. Thi procedure hould be conidered for patient in whom long-term preure control at a lower level would be beneficial in preventing further optic nerve damage.