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Abstract #8023 Published in IGR 4-3
Phacoemulsification with intraocular lens implantation after trabeculectomy
Casson R; Rahman R; Salmon JFJournal of Glaucoma 2002; 11: 429-433
PURPOSE: To determine the effect of phacoemulsification with intraocular lens (IOL) implantation, using a superior clear-corneal incision, on the long-term intraocular pressure (IOP) control in patients who have undergone previous trabeculectomy. METHODS: Twenty-eight consecutive patients who underwent phacoemulsification with IOL implantation (phaco group) at least three months after trabeculectomy were identified and matched to 28 patients who underwent trabeculectomy only (trabeculectomy-only group) with respect to age, gender, IOP, and duration of follow-up. The mean IOP was compared one and two years after phacoemulsification, and the surgical success rate in each group was determined by Kaplan-Meier survival analysis. RESULTS: The mean IOP one year after cataract surgery was significantly higher (p = 0.025) in the phaco group (15.6 ± 3.5 mmHg) than in the trabeculectomy-only group (13.4 ± 2.5 mmHg), but at two years, the difference was not statistically significant (15.3 ± 3.1 mmHg in the phaco group compared with 14.3 ± 3.2 mmHg in the trabeculectomy-only group; p = 0.35). Two years after surgery, five of 28 patients in the phaco group and one of 28 patients in the trabeculectomy-only group had commenced or were using additional topical medication (p = 0.089). If the introduction of glaucoma medication was considered a 'failure', then the IOP control was significantly better in the trabeculectomy-only group using two different criteria for surgical failure. CONCLUSIONS: Although phacoemulsification and IOL implantation through a superior clear-corneal incision have little effect on mean IOP in a group of patients who have undergone previous trabeculectomy, this procedure may jeopardize the long-term IOP control in individual patients.
R. Casson, MD, Nuffield Laboratory of Ophthalmology, Oxford University, UK
Classification:
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
