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Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries

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Published on: July 7, 2023

Deterioration of filtering bleb morphology and function after phacoemulsification.

Monika Sałaga-Pylak¹, Małgorzata Kowal, Tomasz Zarnowski

¹Chair of Ophthalmology, Medical University of Lublin, Chmielna Str No 1, 20-079 Lublin, Poland.

BMC Ophthalmology

|April 27, 2013

Summary

Phacoemulsification significantly increases intraocular pressure (IOP) and worsens filtering bleb morphology in patients previously treated with trabeculectomy for glaucoma.

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Area of Science:

Ophthalmology
Glaucoma Surgery
Cataract Surgery

Background:

Trabeculectomy is a primary surgical treatment for refractory glaucoma.
Cataract formation is a common complication following trabeculectomy.
This study investigates the impact of cataract surgery on post-trabeculectomy glaucoma management.

Purpose of the Study:

To analyze the effect of phacoemulsification with intraocular lens implantation on filtering bleb morphology and function.
To evaluate intraocular pressure (IOP) changes after combined trabeculectomy and phacoemulsification.

Main Methods:

Retrospective study of 122 eyes with primary open-angle glaucoma.
Study group: 50 eyes with prior trabeculectomy and 5-Fluorouracil, followed by phacoemulsification.
Control group: 72 eyes with trabeculectomy alone; surgical success defined as IOP < 17 mmHg.

Main Results:

The combined surgery group showed significantly higher mean IOP at 6, 12, and 18 months post-operatively.
Filtering blebs exhibited greater reduction in size in the phacoemulsification group compared to the control group.
Cox regression analysis indicated lower long-term surgical success rates for the combined surgery group (71-75%) versus trabeculectomy alone (91-92%).

Conclusions:

Phacoemulsification leads to a significant increase in IOP in eyes that have undergone prior trabeculectomy.
The procedure negatively impacts the morphology and functional success of filtering blebs.
Combined phacoemulsification and trabeculectomy may compromise long-term IOP control in glaucoma patients.