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Abstract #19226 Published in IGR 3-1
Intraocular pressure and medication control after clear corneal phacoemulsification and AcrySof posterior chamber intraocular lens implantation in patients with filtering blebs
Crichton ACS; Kirker AWJournal of Glaucoma 2001; 10: 38-46
PURPOSE: To determine whether clear corneal phacoemulsification and the implantation of a copolymer acrylic (AcrySof, Alcon, Fort Worth, TX) intraocular lens will maintain the intraocular pressure (IOP) and number of medications in patients with a previous filtering bleb. PATIENTS AND METHODS: This retrospective analysis included 69 consecutive patients with previous trabeculectomy who had a copolymer acrylic intraocular lens implanted during cataract surgery between 1995 and 1999 by a single surgeon (ACSC). RESULTS: Mean IOP significantly decreased from 26.03 mmHg (range, 14.5-70 mmHg; n = 69) before trabeculectomy to 13.58 ± 3.98 mmHg (range, 5-24 mmHg; n = 69) before the cataract extraction. After cataract extraction, the mean IOP increased significantly by 1.49 mmHg (n = 67; p = 0.0013), by 1.85 mmHg (n = 57; p = 0.0005), and by 1.01 mmHg (n = 67; p = 0.042) after six months, one year, and at the patient's last appointment, respectively. When patients whose pressures were purposely increased during cataract surgery were not included (n = 5), the mean increase at the last appointment was not significantly increased (0.54 mmHg; n = 62; p = 0.25). The average number of antiglaucoma medications decreased from 2.93 (range, 1-5; n = 69) before trabeculectomy to 0.36 (range, 0-2; n = 69) before cataract surgery. This mean decreased to 0.34 (range, 0-2; n = 67; p = 0.8366) six months after cataract surgery and increased to 0.49 (range, 0-3; n = 57; p = 0.1029) and 0.62 (range, 0-3; n = 67; p = 0.0006) after one year and at the last appointment, respectively. Of the total study population, two (2.9%) patients required additional glaucoma surgery and 14 (20.3%) patients required additional antiglaucoma medications as compared with their precataract levels. CONCLUSIONS: Clear corneal phacoemulsification and the implantation of a copolymer acrylic (AcrySof, Alcon) posterior chamber intraocular lens statistically increased the number of medications and IOP of patients in our study. These increases, although statistically significant, did not cause a clinically significant deterioration in IOP control.
Dr A.C.S. Crichton, 933 17th Avenue SW, Calgary, Alberta T2T 5R6, Canada
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
