Study shows that phaco does not contribute to IOP reduction in Trabectome surgery

In a study that was just published, we applied a vigorous, automated statistical matching method, called coarsened exact matching, or CEM, to create a highly balanced comparison. This allowed us to delineate any effect of phacoemulsification on the IOP reduction of NeoMedix Trabectome surgery, a procedure that is performed at our center at a high volume. We found that the IOP decrease is equally good in patients with or without same-session cataract removal.The background of this study is that patients with glaucoma commonly have cataracts or will develop them twice as fast as the normal population. Cataract surgery itself can lower IOP by 1.5 mm Hg to 3 mm Hg, possibly due to an ultrasound-mediated trabeculoplasty-like effect on the trabecular meshwork. This effect may occasionally be pronounced: In the first randomized controlled trial that assessed the iStent trabecular micro-bypass (Glaukos) at the time of cataract surgery compared with controls with cataract surgery only, there was not a significant difference in IOP between the groups. Unfortunately, it has long been known that IOP reduction from cataract surgery is not reliable and can instead lead to dangerously high postoperative spikes in up to 69% of patients. This can be prevented with same-session Trabectome surgery.