Rukiye KILIÇ ÜÇGÜL, Ahmet Ozan OLGUN, Ahmet Yücel ÜÇGÜL
Turkish Journal of Clinical and Experimental Ophthalmology - 2026;21(2):64-71
Purpose: To evaluate the one-year efficacy and safety of phacoemulsification combined with Bent Ab Interno Needle Goniectomy (Phaco-BANG) in patients with mild-to-moderate pseudoexfoliative glaucoma (XFG) and coexisting cataract. Methods: This retrospective study included eyes with XFG undergoing combined Phaco-BANG. Preoperative and postoperative intraocular pressure (IOP), number of antiglaucoma medications, visual acuity, surgical success, and complications were analyzed. Complete success was defined as IOP <=21 mmHg with >=20% reduction without medication, and qualified success as the same IOP target with or without medication. Mean IOP and medication changes were compared using paired statistical tests, and Kaplan-Meier analysis was used to estimate survival probability. Results: Thirty-eight eyes of 38 patients were included. Mean preoperative IOP decreased from 33.6 +/- 4.1 mmHg to 17.0 +/- 3.9 mmHg at 12 months (49% reduction, p < 0.001). The mean number of medications reduced from 3.1 +/- 0.4 to 0.4 +/- 0.8 (p < 0.001). Complete and qualified success rates were 71.1% and 97.4%, respectively, at 12 months. Transient hyphema occurred in 13 eyes (34.2%), resolving spontaneously, while early IOP spike occurred in 2 eyes (5.3%) and hypotony secondary to cyclodialysis cleft in 1 eye (2.6%); no sight-threatening complications were observed. Conclusion: Phaco-BANG provides a safe, cost-effective, and implant-free minimally invasive glaucoma surgery achieving substantial IOP and medication reduction in XFG. The results compare favorably with other combined phaco-MIGS techniques, suggesting Phaco-BANG as a valuable alternative for resource-limited settings.
