CO2 Laser-assisted Deep Sclerectomy Combined with Phacoemulsification in Patients with Primary Open-angle Glaucoma and Cataract

PURPOSE: To assess the safety and efficacy of CO2 laser-assisted sclerectomy surgery (CLASS) combined with phacoemulsification in patients with primary open-angle glaucoma (POAG) and visually significant cataracts. MATERIALS AND METHODS: This was a prospective, uncontrolled, interventional case series. Seventeen patients (17 eyes) diagnosed with POAG and cataracts were enrolled starting from November 2015. All subjects underwent CLASS combined with phacoemulsification surgery by the same surgeon. After the surgery, all patients were followed for 12 months. The preoperative to postoperative changes in intraocular pressure (IOP), glaucoma medication requirements, best-corrected visual acuity and adverse events were recorded. RESULTS: The results of 17 eyes of 17 patients were included in the statistical analysis. The baseline mean IOP was 23.94±8.57 mm Hg (mean±SD), and patients used 2.18±0.88 types of antiglaucoma medication. At 12 months postsurgery, the mean IOP was 14.67±2.97 mm Hg, and patients used 0.59±0.87 types of antiglaucoma medication (both P<0.001). The logarithm of the minimal angle of resolution of the best-corrected visual acuity improved from 0.77±0.42 preoperatively to 0.33±0.47 postoperatively (P<0.05). Two patients experienced intraoperative perforation accompanied by iris prolapse. One patient exhibited postoperative choroidal detachment. CONCLUSIONS: CLASS with phacoemulsification may become a safe and effective intervention for patients with POAG and visually significant cataracts.