A Randomised Controlled Trial

BACKGROUND AND AIM: This prospective study was aimed to compare efficacy and safety of combined surgery and sequential surgeries in patients with primary glaucoma and visually significant senile cataract. MATERIALS AND METHODS: 50 consecutive patients having coexisting visually significant senile cataract with primary glaucoma were included in study. Patients underwent detailed history, ocular examination and routine pre operative investigations. Random distribution of patients into sequential surgery group (S) who underwent planned two staged surgeries and combined surgery group (C) who underwent combined surgery with 25 patients each was done with follow up of 3 months. Statistical analysis was done using chi-square test where p value <0.05 was considered statistically significant. RESULTS: The mean IOP achieved at 12 weeks postoperatively was 2 mm of Hg lower for group S compared to group C. Amount of IOP reduction was 10% more for group S. Overall intra-operative complication rate was higher in Group C (52%) compared to Group S (42%), post operative complications were higher in group S (64%) compared to group C (44%). Unaided visual acuity (>6/60) was more in group C (68%) compared to group S (60%). CONCLUSION: Both surgeries were found be statistically comparable in terms of safety and efficacy where sequential surgeries had lower intraoperative complication rate and preferred for more compromised ocular conditions with disadvantage of economic losses and relative visual deprivation until cataract surgery whereas combined surgeries had an advantage of faster visual rehabilitation and disadvantage being higher rate of intraoperative complications.