Single versus Two-Site Phacoemulsification and Mitomycin-C Trabeculectomy

Purpose: to compare the outcomes of single-site versus two-site mitomycin-c (mmc)augmented phacotrabeculectomy.methods: this matched randomized clinical trial included 34 eyes of 30 patients withvisually significant cataracts and poorly controlled glaucoma. equal numbers of eyeswere randomly assigned to the single-site and two-site groups. in the single-siteapproach, phacoemulsification was performed under a superior scleral tunnel followedby trabeculectomy. the two-site approach included a temporal clear corneal phacoemulsificationcombined with a separate superior trabeculectomy. mmc 0.2 mg/ml wassimilarly applied for one minute in both groups.results: patients were followed for a mean period of 13±1.4 (range, 12 to 15) months.mean best corrected visual acuity one year after surgery was 0.6±0.4 logmar in thesingle-site group and 0.4±0.28 logmar in the two-site group (p=0.12). in the single-sitegroup, mean preoperative intraocular pressure (iop) was 26.4±6.6 mmhg which wasdecreased to 14.8±2.5 mmhg, one year after the operation (p<0.001). correspondingfigures for the two-site group were 22.9±3.3 and 13.6±1.7 mmhg respectively (p<0.001).at final follow up no significant difference in iop existed between the study groups.mean number of anti-glaucoma medications was 0.06±0.24 in the two-site group vs0.43±0.5 in the single-site group (p=0.014). the rate of complications was not different between the study groups (p=1).conclusions: both single-site and two-site phacotrabeculectomy improved visual acuitywhich was slightly, but not significantly, better with two-site surgery. final iop wascomparable with both techniques; however, the two-site group required fewer antiglaucoma medications.