Combined Phacoemulsification with Trabecular Aspiration with Differing Outcomes in Pseudoexfoliative Glaucoma - a Retrospective Study

Introduction: The aim of this study was to differentiate the pressure-reducing results following trabecular aspiration combined with small incision cataract surgery in eyes with pseudoexfoliation depending on preoperative pressure and medication score. Patients and Methods: A retrospective analysis was made of 104 exfoliative eyes of 104 patients who underwent combined phaco/trabecular aspiration. Success was defined as a relative reduction of IOP of at least 20 %, absolute IOP of <= 20 mmHg, stable or reduced medication score and a lack of any further pressure-reducing surgery. Results: The success rate was 0.68 and 0.64 after 1 and 2 years. In eyes with medically uncontrolled preoperative IOP (> 20 mmHg) the IOP dropped-significantly from 25.4 +/- 4.3mmHg to 17.0 +/- 3.4 mmHg after two years. In eyes with preoperative controlled IOP the pressure lowering effect was low (17.1 +/- 2.3 to 15.9 +/- 2.3mmHg) with a significant reduction of medication. Conclusions: Combined cataract surgery and trabecular aspiration is a reasonable option in exfoliative eyes with IOP values in the low twenties in order to achieve a reduction of topical medications and to reach a stable IOP level.