Combined cataract and glaucoma procedures, and minimally-invasive glaucoma surgery in particular, have gained increasing interest over the past few years. The aim of this study was to compare the long-term efficacy of combined phaco-trabeculectomy (Phaco-Trab) and combined phacoemulsification plus excimer laser trabeculotomy (Phaco-ELT). Retrospective, non-randomised, comparative, interventional case series of consecutive patients after Phaco-Trab and Phaco-ELT at the University Hospital of Zurich and the Talacker Eye Center Zurich in Switzerland. Inclusion criteria were diagnosis of glaucoma plus vision-impairing coexisting cataract. Primary outcome measures were change in intraocular pressure (IOP), number of anti-glaucoma drugs (AGDs), and best-corrected visual acuity (BCVA) 1 year and 4 years after the procedure. Secondary outcome measures were surgical complications and requirement of postoperative interventions. Success was defined based on the criteria of the Tube-versus-Trabeculectomy study. Mean age was 76.1 ± 8.6 years (29.2 % males; 47.8 % right eyes). Phaco-Trab (n = 62) decreased median IOP from 22.8 to 13.0 at 1 year and to 14.0 mmHg at 4 years. AGDs were reduced from 2 drugs to 0 AGDs at 1 year and 4 years. Median BCVA improved from 0.2 logMAR to 0.0 logMAR at 1 year and 4 years. Phaco-ELT (n = 51) lowered median IOP from 19.0 to 15.0 at 1 year and to 14.0 mmHg (p = 0.002) at 4 years. AGDs were reduced from 2 drugs to 1 AGD at 1 year and 4 years (p = 0.002). BCVA improved from 0.4 logMAR to 0.1 logMAR after 1 year and 4 years. If not stated otherwise, all changes compared to baseline were highly significant (p < 0.001). No perioperative complications occurred; postoperative interventions were performed in 74 % of Phaco-Trab patients. Both surgical procedures reduced IOP and AGDs and improved BCVA significantly and persistently during the entire follow-up period of 4 years with a good safety profile. This study validates Phaco-ELT as an option when post-operative target pressure in the mid-teens would be adequate, whereas Phaco-Trab would be the treatment of choice when IOP in the low teens is desired.

Purpose: To assess the efficacy and safety of a glaucoma procedure to control intraocular pressure (IOP) using the adjustable eyeWatch glaucoma drainage device compared with Ahmed glaucoma valve (AGV) in refractory glaucoma. Patients and Methods: Monocentric, retrospective, comparative clinical trial. Patients suffering from refractory glaucoma after failed surgeries and requiring a further glaucoma procedure including an aqueous shunt were enrolled in this study. The first group AGV included patients with an AGV. The second group eW-B included patients receiving an eyeWatch used in connection with a Baerveldt glaucoma implant. The primary outcome was the success rate, defined as an IOP≤16 mm Hg and reduction of >20% from baseline, and IOP≥5 mm Hg. Secondary outcomes were mean IOP, number of antiglaucoma medications, visual acuity, number and type of complications. Results: Twenty-one patients were included. The mean follow-up time was 13.2±3.4 months. Mean IOP decreased from 24.8±9.0 mm Hg before surgery to 13.8±3.6 mm Hg at 12 months for group AGV, and 27.3±7.0 to 12.8±2.4 mm Hg for group eW-B, respectively (P<0.05). Mean number of glaucoma medications decreased from 3.0±0.7 before surgery to 0.3±0.7 at last control for group AGV, and 2.9±0.8 before surgery to 0.2±0.4 for group eW-B, respectively (P<0.05). The complete and overall success rates were 50% and 58% for group AGV, and 67% and 89% for group eW-B, respectively. Conclusions: The postoperative adjustability of the eyeWatch is believed to help with getting fewer complications and better IOP management whereas AGV cannot be adjusted postoperatively.

IMPORTANCE Accurate determination of intraocular pressure (IOP) is crucial for the diagnosis and management of glaucoma. Objective clinical evaluation of the correction equations for Goldmann applanation tonometry (GAT) is lacking. OBJECTIVES To investigate the difference between corrected and conventional GAT and Pascal dynamic contour tonometry (DCT) measurements, as well as the correlation between discordant IOP values and stage of glaucoma.

The use of GAT correction formulas involves the risk of creating significant error. The correction equations examined showed extensive scatter and resulted in mean IOP values that were lower than the IOP initially measured by GAT. Thus the use of any correction equation may delay diagnosis of glaucoma and should be avoided.