Observational studyBMC ophthalmology2026
Long-term outcomes after phacoemulsification and trabeculectomy in uncontrolled glaucoma and cataract in staged versus combined approaches: a single-center observational study.
Observational study in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
objectiveTo assess the long-term (4 year) outcomes of staged (phacoemulsification ≥6 months prior to trabeculectomy) or combined (phacotrabeculectomy) surgical approaches in patients with uncontrolled glaucoma. METHODS AND ANALYSIS: Patients who underwent trabeculectomy alone (with phacoemulsification at least 6 months before trabeculectomy - staged approach) and simultaneous phacotrabeculectomy (combined approach) were included in this retrospective chart review study. Surgical success was defined as complete (without medication) or qualified (with medication) according to 3 criteria of upper limits: intraocular pressure (IOP) > 21 mmHg (criterion A), > 18 mmHg (B), > 15 mmHg (C). Mean IOP values were compared between groups at each follow-up.
resultsA total of 72 patients (staged n = 35, combined n = 37) were included. No differences in baseline characteristics were observed between groups. The mean age was 72.3 years, almost three-quarters were diagnosed with primary open-angle glaucoma (73.6%), and mean baseline IOP was 26.4 ± 7.2. Mean IOP significantly decreased in both groups. After 4 years of follow-up, patients in the staged group had a significantly lower mean IOP (10.9 ±3.6 vs. 14.8 ± 6.2, p 0.002), a higher surgical success rate according to each criterion, and a lower need of postoperative drugs and manipulation compared to the combined approach.
conclusionIn this study comparing staged and simultaneous approaches with the longest follow-up to date, patients with cataract and glaucoma experience a substantial and comparable reduction in IOP from baseline after both approaches. The analysis is mainly limited by its retrospective, non-randomized design. However, compared to simultaneous phacotrabeculectomy, the staged approach was associated with lower final IOP, higher long-term surgical success, and fewer postoperative interventions.
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