Combined phacoemulsification, intraocular lens implantation, and trabeculectomy

Purpose: To analyze the results of phacoemulsification and posterior chamber intraocular lens (IOL) implantation combined with trabeculectomy. Setting: John Moran Eye Center, University of Utah, Salt Lake City. Methods: Two hundred twelve eyes of 174 patients with glaucoma and cataracts were analyzed retrospectively after cataract removal by phacoemulsification with posterior chamber IOL implantation combined with trabeculectomy. Results: With an average follow-up of 26 months, patients had a significant improvement in visual acuity. The preoperative mean intraocular pressure (IOP) of 23.1 mm Hg decreased postoperatively to 15.9 mm Hg. Mean number of glaucoma medications decreased from 1.85 preoperatively to 0.41 postoperatively. Twenty-one patients (10%) had a postoperative IOP of greater than 21 mm Hg, and seven required trabeculectomy revisions. Conclusion: Combined phacoemulsification, posterior chamber IOL implantation, and trabeculectomy yielded excellent results in the treatment of patients with both cataract and glaucoma.