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Research Article
Masaru Inatani
University of Fukui
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: We aimed to compare the outcomes of trabeculectomy followed by phacoemulsification and trabeculectomy combined with phacoemulsification.
Methods: A total of 141 patients with open-angle glaucoma who underwent trabeculectomy followed by (n = 48) or combined with (n = 93) phacoemulsification were included. We analyzed the data collected in “The Collaborative Bleb-Related Infection Incidence and Treatment Study” (CBIITS), which was a prospective cohort study conducted in 34 clinical centers including 1,249 eyes. The main outcome was the cumulative probabilities of success based on IOP within 5 years. Surgical failure was defined as performance of an additional glaucoma surgery or fulfilling one of the following criteria: preoperative intraocular pressure (IOP) >21 mmHg (A), IOP >18 mmHg (B), or IOP >15 mmHg (C). The secondary outcomes were the cumulative probabilities of success, but data on phacoemulsification during the 5-year follow-up were censored, the risk factors for surgical failure, and Δvisual acuity.
Results: There was no significant difference in the cumulative probabilities of success of the main outcome. When data on phacoemulsification during the 5-year follow-up were censored, the probabilities of success in trabeculectomy followed by phacoemulsification were significantly higher for criteria A (p = 0.02), B (p < 0.01), and C (p < 0.01). Lower preoperative IOP, younger age, and trabeculectomy combined with phacoemulsification were associated with poorer outcome. Trabeculectomy followed by phacoemulsification had significantly worse Δ logMAR visual acuity at 6 and 12 months (p < 0.01).
Conclusion: The cumulative probabilities of success after trabeculectomy combined with or followed by phacoemulsification remained unchanged. Combining phacoemulsification adversely affects the cumulative probabilities of success after trabeculectomy. Visual acuity improvements noted in the early postoperative period after combining phacoemulsification disappeared within 5 years.
Keywords
Trabeculectomy, Phacoemulsification, Open angle glaucoma
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CURRENT STATUS: Under Review
Version 1
Posted 12 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 09 Mar, 2021
Reviewer #13 agreed
On 08 Mar, 2021
Reviewer #17 agreed
On 08 Mar, 2021
Review #20 received
Received 07 Mar, 2021
Review #18 received
Received 07 Mar, 2021
Review #2 received
Received 07 Mar, 2021
Review #15 received
Received 07 Mar, 2021
Review #21 received
Received 07 Mar, 2021
Review #3 received
Received 07 Mar, 2021
Review #1 received
Received 07 Mar, 2021
Review #13 received
Received 07 Mar, 2021
Review #19 received
Received 07 Mar, 2021
Review #4 received
Received 07 Mar, 2021
Reviewer #19 agreed
On 07 Mar, 2021
Reviewer #14 agreed
On 07 Mar, 2021
Reviewer #23 agreed
On 06 Mar, 2021
Reviewer #3 agreed
On 06 Mar, 2021
Reviewer #21 agreed
On 06 Mar, 2021
Reviewer #18 agreed
On 06 Mar, 2021
Reviewer #24 agreed
On 06 Mar, 2021
Reviewer #16 agreed
On 06 Mar, 2021
Reviewer #27 agreed
On 05 Mar, 2021
Reviewer #7 agreed
On 05 Mar, 2021
Reviewer #25 agreed
On 05 Mar, 2021
Reviewer #9 agreed
On 05 Mar, 2021
Reviewer #22 agreed
On 05 Mar, 2021
Reviewer #2 agreed
On 05 Mar, 2021
Reviewer #4 agreed
On 05 Mar, 2021
Reviewer #28 agreed
On 05 Mar, 2021
Reviewer #10 agreed
On 05 Mar, 2021
Reviewer #8 agreed
On 05 Mar, 2021
Reviewer #6 agreed
On 05 Mar, 2021
Reviewer #1 agreed
On 05 Mar, 2021
Reviewer #20 agreed
On 05 Mar, 2021
Reviewer #26 agreed
On 05 Mar, 2021
Reviewer #11 agreed
On 05 Mar, 2021
Reviewer #5 agreed
On 05 Mar, 2021
Reviewers invited
Invitations sent on 04 Mar, 2021
Editor assigned
On 04 Mar, 2021
Editor invited
On 04 Mar, 2021
Submission checks complete
On 04 Mar, 2021
First submitted
On 25 Feb, 2021
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Subject Areas
Ophthalmology
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This preprint is under consideration at BMC Ophthalmology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Masaru Inatani
University of Fukui
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 12 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 09 Mar, 2021
Reviewer #13 agreed
On 08 Mar, 2021
Reviewer #17 agreed
On 08 Mar, 2021
Review #20 received
Received 07 Mar, 2021
Review #18 received
Received 07 Mar, 2021
Review #2 received
Received 07 Mar, 2021
Review #15 received
Received 07 Mar, 2021
Review #21 received
Received 07 Mar, 2021
Review #3 received
Received 07 Mar, 2021
Review #1 received
Received 07 Mar, 2021
Review #13 received
Received 07 Mar, 2021
Review #19 received
Received 07 Mar, 2021
Review #4 received
Received 07 Mar, 2021
Reviewer #19 agreed
On 07 Mar, 2021
Reviewer #14 agreed
On 07 Mar, 2021
Reviewer #23 agreed
On 06 Mar, 2021
Reviewer #3 agreed
On 06 Mar, 2021
Reviewer #21 agreed
On 06 Mar, 2021
Reviewer #18 agreed
On 06 Mar, 2021
Reviewer #24 agreed
On 06 Mar, 2021
Reviewer #16 agreed
On 06 Mar, 2021
Reviewer #27 agreed
On 05 Mar, 2021
Reviewer #7 agreed
On 05 Mar, 2021
Reviewer #25 agreed
On 05 Mar, 2021
Reviewer #9 agreed
On 05 Mar, 2021
Reviewer #22 agreed
On 05 Mar, 2021
Reviewer #2 agreed
On 05 Mar, 2021
Reviewer #4 agreed
On 05 Mar, 2021
Reviewer #28 agreed
On 05 Mar, 2021
Reviewer #10 agreed
On 05 Mar, 2021
Reviewer #8 agreed
On 05 Mar, 2021
Reviewer #6 agreed
On 05 Mar, 2021
Reviewer #1 agreed
On 05 Mar, 2021
Reviewer #20 agreed
On 05 Mar, 2021
Reviewer #26 agreed
On 05 Mar, 2021
Reviewer #11 agreed
On 05 Mar, 2021
Reviewer #5 agreed
On 05 Mar, 2021
Reviewers invited
Invitations sent on 04 Mar, 2021
Editor assigned
On 04 Mar, 2021
Editor invited
On 04 Mar, 2021
Submission checks complete
On 04 Mar, 2021
First submitted
On 25 Feb, 2021
Subject Areas
Ophthalmology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: We aimed to compare the outcomes of trabeculectomy followed by phacoemulsification and trabeculectomy combined with phacoemulsification.
Methods: A total of 141 patients with open-angle glaucoma who underwent trabeculectomy followed by (n = 48) or combined with (n = 93) phacoemulsification were included. We analyzed the data collected in “The Collaborative Bleb-Related Infection Incidence and Treatment Study” (CBIITS), which was a prospective cohort study conducted in 34 clinical centers including 1,249 eyes. The main outcome was the cumulative probabilities of success based on IOP within 5 years. Surgical failure was defined as performance of an additional glaucoma surgery or fulfilling one of the following criteria: preoperative intraocular pressure (IOP) >21 mmHg (A), IOP >18 mmHg (B), or IOP >15 mmHg (C). The secondary outcomes were the cumulative probabilities of success, but data on phacoemulsification during the 5-year follow-up were censored, the risk factors for surgical failure, and Δvisual acuity.
Results: There was no significant difference in the cumulative probabilities of success of the main outcome. When data on phacoemulsification during the 5-year follow-up were censored, the probabilities of success in trabeculectomy followed by phacoemulsification were significantly higher for criteria A (p = 0.02), B (p < 0.01), and C (p < 0.01). Lower preoperative IOP, younger age, and trabeculectomy combined with phacoemulsification were associated with poorer outcome. Trabeculectomy followed by phacoemulsification had significantly worse Δ logMAR visual acuity at 6 and 12 months (p < 0.01).
Conclusion: The cumulative probabilities of success after trabeculectomy combined with or followed by phacoemulsification remained unchanged. Combining phacoemulsification adversely affects the cumulative probabilities of success after trabeculectomy. Visual acuity improvements noted in the early postoperative period after combining phacoemulsification disappeared within 5 years.
Figure 1
Figure 2
Figure 3
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