Open Access Indonesian Journal of Medical Reviews
Vol. 6 No. 5 (2026): Open Access Indonesian Journal of Medical Reviews

Visual Acuity, Not Pressure Control, Distinguishes Phacotrabeculectomy from Trabeculectomy in Primary Open-Angle Glaucoma: A Six-Month Comparative Cohort Study

Fitratul Ilahi (Department of Ophthalmology, Faculty of Medicine, Universitas Andalas, Padang, Indonesia)
Hafiz Shatari (Department of Ophthalmology, Faculty of Medicine, Universitas Andalas, Padang, Indonesia)
Lucyana (Department of Ophthalmology, Faculty of Medicine, Universitas Andalas, Padang, Indonesia)



Article Info

Publish Date
16 Sep 2026

Abstract

Background: Primary open-angle glaucoma often coexists with cataract, but Indonesian evidence comparing trabeculectomy with combined phacotrabeculectomy is scarce. Objective: To compare six-month pressure, medication, surgical, and visual outcomes after trabeculectomy versus phacotrabeculectomy and quantify between-group precision. Methods: This retrospective, non-randomised comparative cohort included 74 consecutive patients with primary open-angle glaucoma (54 trabeculectomy; 20 phacotrabeculectomy) at an Indonesian university ophthalmology department. Outcomes were intraocular pressure, topical medication burden, surgical success, and visual acuity. Within-group changes used paired t tests with Holm adjustment; between-group contrasts used Welch and Fisher exact tests, Hedges g, and Newcombe intervals. Result: Pressure fell at every timepoint in both groups (all adjusted p < 0.001). Six-month reductions were 13.02 and 12.10 mmHg; the between-group difference was 0.92 mmHg (95% CI −5.27 to 3.43; p = 0.670). Complete success was 55.6% versus 75.0% (odds ratio 2.40, 95% CI 0.76–7.55; p = 0.181). Visual acuity favoured phacotrabeculectomy (0.37 versus 0.99 logMAR; Hedges g = 0.70, 95% CI 0.18–1.23; p = 0.020). The cohort could not resolve pressure differences below 5.99 mmHg. Conclusion: Both procedures achieved large, sustained reductions in pressure and medication burden; equivalence in pressure control was not established. Phacotrabeculectomy produced better visual acuity, although cataract confounded procedure selection and acuity. When cataract coexists with primary open-angle glaucoma, the combined procedure may provide comparable pressure control and better acuity in one admission.

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Journal Info

Abbrev

OAIJMR

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Open Access Indonesian Journal of Medical Reviews (OAIJMR) is a bi-monthly, international, peer-review, and open access journal dedicated to various disciplines of medicine, biology and life sciences. The journal publishes all type of review articles, narrative review, meta-analysis, systematic ...