Objective:

To report on the tonometric success (defined as the achievement of target intraocular pressure) and medication use after 4 years of follow-up among patients with uncontrolled glaucoma and coexisting cataract treated with either a staged or combined surgical approach.

Approach:

Key Findings:

• Both staged and combined approaches significantly decreased intraocular pressure (IOP).
• The staged approach was associated with lower mean IOP, less need for bleb needling, and higher procedural success rates (defined as achieving target IOP without additional surgery).
• Previous studies reported conflicting results, highlighting the need for longer-term outcomes.

Interpretation:

The findings suggest that a staged approach may provide better long-term IOP control and fewer complications compared to a combined approach in patients with uncontrolled glaucoma and cataract, potentially leading to improved patient outcomes.

Limitations:

• Retrospective design may introduce selection bias and limit causal inferences.
• Study conducted at a single center, limiting generalizability.
• Potential confounding factors not fully controlled.

Conclusion:

The staged approach may be preferable for better IOP management and fewer complications in patients with uncontrolled glaucoma and cataract.

Source

Based on findings from:

Outcomes of Phacoemulsification and Trabeculectomy for Uncontrolled Glaucoma and Cataract: A Comparison of Staged and Combined Techniques in a Single-Center Observational Study

Matteo Sacchi, Gianluca Monsellato, Davide Rastelli, Shadan Ranaei, Davide Tomaselli, Gaia Li Calzi, Edoardo Villani, Stefano Dore, Antonio Pinna, Paolo Nucci. Bmc Ophthalmology, 2026.

https://link.springer.com/article/10.1186/s12886-026-04643-w

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