Comparative Study of Phaco-Trabeculectomy and Small Incision Cataract Surgery Trabeculectomy in 50 Cataract Patients
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IJAR JOURNALComparative Study of Phaco-Trabeculectomy and Small Incision Cataract Surgery Trabeculectomy in 50 Cataract Patients
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IJAR JOURNALISSN: 2320-5407 Int. J. Adv. Res.
13(01), 795-798
Journal Homepage: -www.journalijar.com
Article DOI:10.21474/IJAR01/20261
DOI URL: http://dx.doi.org/10.21474/IJAR01/20261
RESEARCH ARTICLE
COMPARATIVE STUDY OF PHACO-TRABECULECTOMY AND SMALL INCISION CATARACT
SURGERY TRABECULECTOMY IN 50 CATARACT PATIENTS
Anjali Kapase1 and Rahul Pawar2
1. Associate Professor, Department of Ophthalmology, DVVPF’s Medical College & Hospital, Ahmednagar,
Maharashtra, India.
2. Junior Resident, Department of Ophthalmology, DVVPF’s Medical College & Hospital, Ahmednagar,
Maharashtra, India.
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Manuscript Info Abstract
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Manuscript History Objective: To compare the clinical outcomes and complications of
Received: 16 November 2024 phaco-trabeculectomy and small incision cataract surgery (SICS)
Final Accepted: 18 December 2024 trabeculectomy in patients with cataracts.
Published: January 2025 Methods: A prospective study was conducted involving 50 cataract
patients divided into two groups: 25 patients underwent phaco-
trabeculectomy and 25 underwent SICS trabeculectomy. Preoperative
and postoperative parameters such as intraocular pressure (IOP), visual
acuity (VA), surgical time, and complication rates were analyzed.
Results: The study showed that both phaco-trabeculectomy and SICS
trabeculectomy effectively reduced intraocular pressure and improved
visual acuity. However, phaco-trabeculectomy had a significantly
shorter surgical time and fewer postoperative complications compared
to SICS trabeculectomy.
Conclusion:Phaco-trabeculectomy offers better safety and efficacy
compared to SICS trabeculectomy, making it a preferable choice for
managing cataract patients requiring trabeculectomy.
Copyright, IJAR, 2025,. All rights reserved.
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Introduction:-
Cataracts and glaucoma often coexist, necessitating a surgical approach that addresses both conditions
simultaneously. Phaco-trabeculectomy and SICS trabeculectomy are two surgical techniques that have gained
prominence in managing cataracts with coexisting glaucoma.
Phaco-trabeculectomy combines phacoemulsification and trabeculectomy, offering the advantage of minimal
invasiveness and quicker recovery. In contrast, SICS trabeculectomy, while effective, may be associated with a
longer recovery time and higher complication rates.
This study aims to provide a comparative analysis of the two surgical techniques in terms of intraocular pressure
control, visual acuity improvement, surgical time, and postoperative complications, offering insights into the optimal
surgical choice for cataract patients with glaucoma.
Corresponding Author:-Anjali Kapase
Address:-Assistant Professor, Department of Ophthalmology, DVVPF’s Medical
College & Hospital, Ahmednagar, Maharashtra, India. 795
ISSN: 2320-5407 Int. J. Adv. Res. 13(01), 795-798
Methodology:-
Study Design
A prospective, randomized study was conducted at DVVPF’s Medical College &Hospital between December 2023
and November 2024. The study included 50 cataract patients diagnosed with coexisting glaucoma.
Patient Selection
Inclusion Criteria:
o Patients aged 50-80 years with confirmed cataract and glaucoma.
o No previous ocular surgery.
o Informed consent obtained.
Exclusion Criteria:
o Secondary glaucoma.
o Advanced diabetic retinopathy.
o Other ocular comorbidities affecting vision.
Surgical Procedures
Phaco-Trabeculectomy Group (n=25):
o Standard phacoemulsification with foldable IOL implantation.
o Trabeculectomy performed with mitomycin-C application.
o Sutures applied as required.
SICS-Trabeculectomy Group (n=25):
o Manual small incision cataract surgery with rigid IOL implantation.
o Trabeculectomy with mitomycin-C.
o Suturing according to standard protocol.
Outcome Measures
1. Intraocular Pressure (IOP): Measured preoperatively, and postoperatively at 1 week, 1 month, 3 months, and
6 months using Goldmann applanation tonometry.
2. Visual Acuity (VA): Assessed using Snellen's chart at the same intervals.
3. Surgical Time: Recorded from incision to the closure of the surgical site.
4. Complications: Documented intraoperative and postoperative complications, including hyphema, shallow
anterior chamber, and infection.
Statistical Analysis
Paired t-test was used to compare preoperative and postoperative IOP and VA within each group. An independent t-
test was utilized to compare outcomes between the two groups. A p-value < 0.05 was considered statistically
significant.
Results:-
Demographics and Baseline Characteristics
Parameter Phaco-Trab Group SICS-Trab Group (n=25) p-value
(n=25)
Age (mean ± SD) 67.4 ± 8.2 68.1 ± 7.5 0.721
Male/Female Ratio 14/11 13/12 0.793
Preoperative IOP (mmHg) 23.8 ± 2.4 24.1 ± 2.1 0.598
Preoperative VA 0.54 ± 0.12 0.56 ± 0.11 0.455
(logMAR)
Intraocular Pressure (IOP) Reduction
Phaco-Trab Group SICS-Trab Group
Time Point p-value
(mmHg) (mmHg)
Preoperative 23.8 ± 2.4 24.1 ± 2.1 0.598
1 Week Post-op 15.3 ± 1.8 16.5 ± 2.0 0.032*
1 Month Post-op 14.9 ± 1.7 16.2 ± 1.8 0.017*
3 Months Post-op 14.5 ± 1.6 15.9 ± 1.7 0.014*
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ISSN: 2320-5407 Int. J. Adv. Res. 13(01), 795-798
6 Months Post-op 14.3 ± 1.5 15.7 ± 1.6 0.011*
*Statistically significant at p < 0.05.
Visual Acuity Improvement
Phaco-Trab Group SICS-Trab Group
Time Point p-value
(logMAR) (logMAR)
Preoperative 0.54 ± 0.12 0.56 ± 0.11 0.455
1 Week Post-op 0.38 ± 0.10 0.42 ± 0.12 0.094
1 Month Post-op 0.34 ± 0.09 0.39 ± 0.11 0.047*
3 Months Post-op 0.32 ± 0.08 0.37 ± 0.10 0.039*
6 Months Post-op 0.31 ± 0.07 0.36 ± 0.09 0.034*
*Statistically significant at p < 0.05.
Surgical Time
Phaco-Trab Group SICS-Trab Group
Parameter p-value
(minutes) (minutes)
Surgical Time 45.2 ± 6.4 59.1 ± 7.3 <0.001*
*Statistically significant at p < 0.05.
Complications
Complication Type Phaco-Trab Group (n=25) SICS-Trab Group (n=25)
Hyphema 2 4
Shallow Anterior Chamber 1 3
Endophthalmitis 0 1
Choroidal Detachment 1 2
Total 4 10
Discussion:-
This study demonstrates the comparative efficacy of phaco-trabeculectomy and SICS trabeculectomy in managing
cataracts with coexisting glaucoma. The phaco-trabeculectomy group showed superior outcomes in terms of IOP
reduction, visual acuity improvement, and fewer complications.
Intraocular Pressure Control:
Phaco-trabeculectomy consistently achieved lower postoperative IOP levels, likely due to the precise control offered
by phacoemulsification and the effective filtration provided by trabeculectomy. This finding aligns with previous
studies highlighting the effectiveness of combined procedures in managing intraocular pressure in glaucoma
patients.
Visual Acuity Improvement:
Patients in the phaco-trabeculectomy group experienced a more significant improvement in visual acuity, reflecting
the minimal invasiveness and superior IOL technology associated with phacoemulsification. The use of foldable
IOLs in phaco-trabeculectomy offers better optical quality and visual outcomes.
Surgical Time:
The shorter surgical time in the phaco-trabeculectomy group is noteworthy, reflecting the efficiency of modern
phacoemulsification techniques. Reduced surgical time correlates with less intraoperative stress and faster patient
recovery.
Complications:
The phaco-trabeculectomy group had fewer complications, suggesting a more favorable safety profile. The higher
complication rates in the SICS-trabeculectomy group may be attributed to the manual nature of the procedure and
the larger incision required, which increases the risk of postoperative issues.
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ISSN: 2320-5407 Int. J. Adv. Res. 13(01), 795-798
Limitations:
This study's limitations include a relatively small sample size and a single-center design, which may limit the
generalizability of the findings. Further multicenter studies with larger cohorts are needed to validate these results.
Conclusion:-
Phaco-trabeculectomy is superior to SICS trabeculectomy in managing cataract patients with coexisting glaucoma,
offering better intraocular pressure control, visual acuity outcomes, and fewer complications. These findings support
the adoption of phaco-trabeculectomy as a preferred surgical approach in this patient population.
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3. Zhao Y, Chen X, Wang X. (2017). Comparison of visual outcomes and complications after
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