Long-term comparison of postoperative refractive outcomes between phacotrabeculectomy and phacoemulsification

Purpose: To compare long-term postoperative refractive outcomes between phacotrabeculectomy and phacoemulsification, both with posterior chamber intraocular lens implantation. Setting: Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Seoul, South Korea. Design: Retrospective comparative study. Methods: Postoperative refractive outcomes were compared between patients with cataract and coexisting primary or secondary open-angle glaucoma (OAG) who had phacotrabeculectomy (combined group) and patients with cataract with or without coexisting OAG who had phacoemulsification alone (phaco-only group). The refractive prediction error, mean absolute error, and median absolute error were compared between groups. Subgroup analysis based on preoperative axial length (AL) was performed (medium >22.0 to <24.5 mm; medium-long >= 24.5 to <26.0 mm; long >= 26.0 mm). Results: The combined group comprised 51 eyes and the phaco-only group, 74 eyes. The mean interval between surgery and refraction measurement was 14.70 months +/- 10.80 (SD) (median 13.0 months) and 4.81 +/- 4.97 months (median 2.0 months), respectively. Postoperatively, there was no statistically significant between-group difference in the following mean values: refractive prediction error, -0.05 +/- 0.64 versus -0.04 +/- 0.52 (P = .905); mean absolute error, 0.46 +/- 0.44 versus 0.38 +/- 0.36 (P = .258); median absolute error, 0.32 (interquartile range [IQ% 0.17, 0.67) versus 0.28 (10R, 0.13, 0.54) (P = .297). Subgroup analysis also did not show significant differences between the 2 groups (all P > .05). Conclusion: The long-term postoperative refractive outcomes of phacotrabeculectomy and phacoemulsification alone were not significantly different in eyes with OAG, regardless of preoperative AL.