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Abstract #27814 Published in IGR 13-1
Trabeculectomy with mitomycin for open-angle glaucoma in phakic vs pseudophakic eyes after phacoemulsification
Takihara Y; Inatani M; Seto T; Iwao K; Iwao M; Inoue T; Kasaoka N; Murakami A; Futa R; Tanihara HArchives of Ophthalmology 2011; 129: 152-157
Objective: To determine whether previous phacoemulsification adversely affects surgical prognosis of trabeculectomy with mitomycin for open-angle glaucoma. Methods: The study is a retrospective, consecutive, comparative case series. At 2 clinical centers, we reviewed 226 medical records of eyes with open-angle glaucoma undergoing initial trabeculectomy, including 175 phakic eyes (phakic group) and 51 pseudophakic eyes that had previously undergone phacoemulsification with superior conjunctival incision (pseudophakic group). Primary outcome was the probability of success after trabeculectomy. Surgical failure was defined as an additional glaucoma surgery or 1 of the following 3 criteria: intraocular pressure (IOP) of 21mmHg or greater (A); IOP of 18mmHg or greater (B); and IOP of 15mmHg or greater (C). Multivariable analysis was performed using the Cox proportional hazards model. Results: The mean follow-up period was 37.5 months. The probability of success for criteria A, B, and C at 1 and 3 years in the phakic vs the pseudophakic group was 97.8% and 92.6%, respectively, vs 78.6% and 65.1%, respectively, for criterion A (P<.001); 92.9% and 81.3%, respectively, vs 72.8% and 63.7%, respectively, for criterion B (P=.004); and 73.1% and 54.2%, respectively, vs 53.1% and 38.4%, respectively, for criterionC(P=.009). The multivariable model confirmed that pseudophakia independently contributes to surgical failure (criterion A relative risk, 4.59 [P<.001]; criterion B, 2.88 [P=.004]; and criterion C, 2.02 [P=.009]). The pseudophakic group required more postoperative laser suture lysis (P=.01). Conclusion: Previous phacoemulsification is a prognostic factor for surgical failure of trabeculectomy with mitomycin for open-angle glaucoma.
M. Inatani. Department of Ophthalmology and Visual Science, Kumamoto University, Graduate School of Medical Sciences, 1-1-1 Honjo, Kumamoto City 860-8556, Japan. inatani@kumamoto-u.ac.jp
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)