Review Article May 28, 2025 May 28, 2025

Phacoviscocanalostomy versus phacoemulsification alone for glaucoma associated with cataract: a meta-analysis

DOI: 10.37039/1982.8551.20250034

ABSTRACT

Objective:

This systematic review and meta-analysis compare the safety and efficacy of phacoemulsification alone versus combined phacoviscocanalostomy in glaucoma and cataract patients.

Methods:

We followed PRISMA guidelines. PubMed®, Web of Science, Cochrane, and Embase were searched for randomized clinical trial and non-randomized clinical trial studies comparing phaco versus phacoviscocanalostomy in patients with any glaucoma and cataract type. Statistical analysis was conducted using RevMan software.

Results:

The study included 889 patients from one randomized clinical trial and three non-randomized clinical trials studies, of whom 499 (56.1%) received phacoviscocanalostomy. Patients treated with phacoviscocanalostomy had significantly lower intraocular pressure at 1 (mean difference: 3.90; p < 0.00001), 3 (mean difference: 2.52; p = 0.03), 6 (mean difference: 1.90; p = 0.04), 18 (mean difference: 3.23; p < 0.00001) and 24 months (mean difference: 2.55; p < 0.00001), except for 12 months (mean difference: 2.26; p = 0.08). A lower medication at six months (mean difference: 0.68; p < 0.00001), no difference in the visual acuity (mean difference: −0.02; p = 0.77), and a higher rate of adverse events (odds ratios: 236.96; p = 0.004) were found.

Conclusions:

The combined phacoviscocalanostomy approach showed positive outcomes, without increasing the severe complication rates.