Intra-individual comparison after combined phaco-trabecular aspiration in pairs of pseudoexfoliative eyes

Trabecular aspiration is used for combined glaucoma-cataract surgery in coexisting pseudoexfoliation syndrome (XFS) or glaucoma (XFG). Reports on this technique are limited to a few small-scale studies. In this study, we wanted to elucidate whether the result of combined phacoemulsification with trabecular aspiration in the first operated eye is predictive for outcome in the contralateral eye. In a retrospective analysis we compared the results from 80 eyes of 40 patients with pseudoexfoliation syndrome or glaucoma, who had undergone bilateral but consecutive phacoemulsification with implantation of a posterior chamber lens combined with trabecular aspiration between 2003 and 2005. The IOP level and medication score after phaco-trabecular aspiration were shown to be significantly lower than the preoperative values after 2 years (p < 0.0001 and p = 0.047). A significant correlation between the first and second eye was detected for reduction of IOP and medication score after 1 year. Kaplan-Meier graphs of the first and second eyes showed an almost parallel trend from 1 day after surgery until 35 months after surgery. The postoperative outcome in an eye after combined phaco-trabecular aspiration is predictive for the second eye. If this procedure succeeded in the first eye, the prognosis for the same strategy in the fellow eye is also good.