Combined surgery for cataract and glaucoma: phacoemulsification and deep sclerectomy compared with phacoemulsification and trabeculectomy

J Cataract Refract Surg. 1999 Mar;25(3):340-6. doi: 10.1016/s0886-3350(99)80081-9.


Purpose: To compare the outcome of phacoemulsification-intraocular lens (IOL) implantation combined with nonperforating deep sclerectomy (P-DS) with that of phacoemulsification-IOL implantation combined with trabeculectomy (P-T).

Setting: Glaucoma Unit, Department of Ophthalmology, University of Lausanne, Switzerland.

Methods: This prospective study involved 60 eyes of 60 patients with cataract and various types of open-angle glaucoma. Thirty eyes had P-DS and 30, P-T. Follow-up was performed at regular intervals for up to 18 months.

Results: Mean follow-up was 12.5 months +/- 6.5 (SD) and 12.6 +/- 4.9 months for the P-DS and P-T groups, respectively. Mean preoperative intraocular pressure (IOP) was similar in both groups (24.8 +/- 5.9 mm Hg in the P-DS group and 24.6 +/- 7.2 mm Hg in the P-T group). There was no statistically significant difference in IOP decrease (14.2 +/- 4.0 mm Hg in the P-DS group and 15.2 +/- 2.8 mm Hg in the P-T group). Visual outcome was similar in both groups. The P-DS group experienced significantly less inflammation (40.0% versus 83.0%; P = .0012) and hyphema (6.7% versus 36.7%; P = .010) than the P-T group.

Conclusion: Deep sclerectomy combined with cataract surgery resulted in an IOP reduction similar to that with phacotrabeculectomy with the same visual outcome, but the lower complication rate makes ambulatory care easier.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cataract / complications
  • Female
  • Follow-Up Studies
  • Glaucoma, Open-Angle / complications
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Intraocular Pressure
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Phacoemulsification / methods*
  • Postoperative Complications
  • Prospective Studies
  • Sclerostomy / methods*
  • Trabeculectomy / methods*
  • Treatment Outcome
  • Visual Acuity