Temporal corneal phacoemulsification in patients with filtered glaucoma
H. J. Park, Y. H. Kwon, M. Weitzman and J. Caprioli
Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Conn., USA.
OBJECTIVE: To evaluate the effect of temporal clear corneal
phacoemulsification on intraocular pressure (IOP) in eyes that underwent
prior trabeculectomy. DESIGN: Retrospective case-control study. PATIENTS:
Forty consecutive patients who underwent temporal clear corneal
phacoemulsification subsequent to trabeculectomy
(trabeculectomy-phacoemulsification group) were identified, and 40 control
patients who underwent trabeculectomy alone (trabeculectomy group) were
matched to the case patients for length of follow-up, age, IOP, number of
antiglaucoma medications, number of 5-fluorouracil injections, race, sex,
and diagnosis. MAIN OUTCOME MEASURES: Intraocular pressure before vs 1 year
after phacoemulsification in the trabeculectomy-phacoemulsification group
compared with IOP in the trabeculectomy group and survival analysis of IOP
control after trabeculectomy in the 2 groups. RESULTS: In the
trabeculectomy-phacoemulsification group, IOP 1 year after
phacoemulsification was not significantly different from the
prephacoemulsification IOP value (P = .65). Kaplan-Meier survival analysis
showed that the rates of IOP control 3, 6, and 9 years after trabeculectomy
in the trabeculectomy-phacoemulsification group were 80%, 66%, and 44%,
respectively; in the trabeculectomy group, these were 79%, 69%, and 55%,
respectively. These survival curves were not statistically different (P =
.55). CONCLUSION: Cataract surgery by temporal clear corneal
phacoemulsification in eyes with filtering blebs after trabeculectomy does
not adversely affect long-term IOP control.
