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Objective <p>To evaluate the efficacy and safety of phacoemulsification with intraocular lens implantation (PEI) combined with 120° goniotomy (GT) versus PEI combined with trabeculectomy (Trab) in advanced Pseudoexfoliative glaucoma (PXG) with cataracts.</p> Methods <p>A retrospective study included 68 advanced PXG with cataract patients (68 eyes): 32 underwent PEI + GT and 36 underwent PEI + Trab. The visual acuity, intraocular pressure(IOP), the number of glaucoma medications, surgical success rate, complications, postoperative interventions, surgery duration, and quality of life (EQ-5D-5L) were recorded preoperatively and at 1, 3, 6, and 12 months postoperatively.</p> Results <p>The PEI + GT group had a higher 1-month IOP than PEI + Trab (15.7 ± 1.7 vs. 13.9 ± 2.3 mmHg; <i>P</i>&lt;0.05). Both groups experienced a significant reduction in the IOP and the number of medications used postoperatively (all <i>P</i>&lt;0.05).The cumulative success rate and early complication incidence were comparable between the groups (<i>P</i>&gt;0.05).PEI + GT demonstrated significantly lower rates of late complications and postoperative interventions, shorter operative time (16.8 ± 3.1 vs. 34.5 ± 5.5&#xa0;min), and higher postoperative quality of life (EQ-5D-5L) compared to PEI + Trab (all <i>P</i> &lt; 0.05).</p> Conclusion <p>Both PEI + GT and PEI + Trab effectively reduced IOP and glaucoma medication use in PXG patients with cataract. However, PEI + GT demonstrated shorter surgery duration, fewer late complications, reduced need for postoperative interventions, better surgery safety, and higher postoperative quality of life than PEI + Trab.</p>

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Efficacy and safety evaluation of phacoemulsification with intraocular lens implantation combined with goniotomy versus combined with trabeculectomy in advanced pseudoexfoliative glaucoma with cataract

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月11日

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  • Fan Li,
  • Guangxian Tang,
  • Ting Wang,
  • Xi Cao,
  • Lihua Ma,
  • Wenwen Tang,
  • Qingli Shang

摘要

Objective

To evaluate the efficacy and safety of phacoemulsification with intraocular lens implantation (PEI) combined with 120° goniotomy (GT) versus PEI combined with trabeculectomy (Trab) in advanced Pseudoexfoliative glaucoma (PXG) with cataracts.

Methods

A retrospective study included 68 advanced PXG with cataract patients (68 eyes): 32 underwent PEI + GT and 36 underwent PEI + Trab. The visual acuity, intraocular pressure(IOP), the number of glaucoma medications, surgical success rate, complications, postoperative interventions, surgery duration, and quality of life (EQ-5D-5L) were recorded preoperatively and at 1, 3, 6, and 12 months postoperatively.

Results

The PEI + GT group had a higher 1-month IOP than PEI + Trab (15.7 ± 1.7 vs. 13.9 ± 2.3 mmHg; P<0.05). Both groups experienced a significant reduction in the IOP and the number of medications used postoperatively (all P<0.05).The cumulative success rate and early complication incidence were comparable between the groups (P>0.05).PEI + GT demonstrated significantly lower rates of late complications and postoperative interventions, shorter operative time (16.8 ± 3.1 vs. 34.5 ± 5.5 min), and higher postoperative quality of life (EQ-5D-5L) compared to PEI + Trab (all P < 0.05).

Conclusion

Both PEI + GT and PEI + Trab effectively reduced IOP and glaucoma medication use in PXG patients with cataract. However, PEI + GT demonstrated shorter surgery duration, fewer late complications, reduced need for postoperative interventions, better surgery safety, and higher postoperative quality of life than PEI + Trab.