1. PHACO-TRAB VERSUS PHACO ONLY IN EYES WITH ADVANCED OR END-STAGE GLAUCOMA WITH CONTROLLED INTRAOCULAR PRESSURE AND VISUALLY SIGNIFICANT CATARACT Liaska A¹., Papakonstantinou D², Theodosiadis P³, Vergados I³ ¹Dpt of Ophthalmology, General Hospital of Lamia, Lamia, Greece ²University of Athens, A’ Department of Ophthalmology, GENNIMATAS Hospital, Athens, Greece ³University of Athens, B’ Department of Ophthalmology, ATTIKON Hospital, Athens, Greece Dpt of Ophthalmology, Hellenic Red Cross Hospital, Athens, Greece

2. Purpose it is estimated that cataract surgery alone has a beneficial effect by mildly lowering the intraocular pressure. However, it is possible that even temporary loss of intraocular pressure (IOP) control may occur after cataract operation. This event may be of utmost importance in eyes with already severely compromised optic nerves. The purpose of the study is to investigate the advantages and disadvantages of phaco-only versus combined phaco-trab operation in eyes with advanced or end stage glaucoma.

3. Patients/Method Prospective study of 67 patients with advanced or end-stage glaucoma with IOP≤21mmHg on topical medication and visually significant cataract (VA ranging from Hand Movements to 4/10). All patients were randomized to have either combined surgery (phaco-trab) (Group A, 33 eyes) or phaco only (Group B, 34 eyes). Follow up for 6 months. Main outcome measures: 1)Visual Acuity (VA) at 1, 3 and 6 months postoperatively.2)Visual Fields test (VF) at 1, 3 and 6 months postop 3) IOP at 1 st, 4 th and 7 th day postop, weekly thereafter until the end of the second month and monthly afterwards until the end of follow up period. Appropriate pressure lowering medication was given whenever the IOP was found to exceed the “21mmHg” barrier.

4. Results all patients experienced improvement of VA. In Group A IOPs were lower by 4mmHg (range 3-10) and this difference was consistent during the whole follow up period. However, the White on White Automated Perimetry did not reveal progression of glaucoma lesions in either Group.

5. Conclusion Higher IOPs postoperatively in phaco- only patients do not seem to have an effect on glaucoma lesions, provided that close IOP monitoring and treatment are taking place, as far as the first six months’ postoperative period is concerned.