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Effect of phacoemulsification on trabeculectomy function.

Dan Q Nguyen1, Nuwan Niyadurupola, Robyn J Tapp

  • 1Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia; Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia; Department of Ophthalmology, Mid-Cheshire Hospitals NHS Foundation Trust, Crewe, UK; Institute for Science & Technology in Medicine, University of Keele, Keele, UK.

Clinical & Experimental Ophthalmology
|December 19, 2013
PubMed
Summary
This summary is machine-generated.

Phacoemulsification after trabeculectomy surgery increased bleb failure rates within 12 months. However, this effect on glaucoma surgery success was not significant at 24 months.

Keywords:
blebcataractglaucomaphacoemulsificationtrabeculectomy

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Cataract Surgery

Background:

  • Trabeculectomy is a common glaucoma surgery to reduce intraocular pressure.
  • Phacoemulsification is a cataract surgery technique.
  • The impact of phacoemulsification on the long-term function of trabeculectomy blebs is not fully understood.

Purpose of the Study:

  • To evaluate the effect of phacoemulsification on the functional outcomes of trabeculectomy.
  • To compare bleb function in patients who underwent phacoemulsification before or after trabeculectomy.

Main Methods:

  • Retrospective case-control study of 48 patients with at least 2 years of follow-up.
  • Patients were divided into two groups: those who had phacoemulsification after trabeculectomy (Trab_phaco) and those who were pseudophakic before trabeculectomy (Phaco_trab).
  • Primary outcomes included achieving target intraocular pressure (IOP) and bleb function failure, defined as the need for additional medical or surgical intervention.

Main Results:

  • No significant difference in achieving target IOP criteria between groups at 12 or 24 months.
  • Significantly higher rates of trabeculectomy failure (requiring additional intervention) were observed in the Trab_phaco group within the first 12 months (39% vs. 10%, P=0.028).
  • This trend of increased failure in the Trab_phaco group was not statistically significant at 24 months (P=0.522).

Conclusions:

  • Phacoemulsification performed subsequent to trabeculectomy is associated with a higher rate of bleb failure within the initial 12 months post-surgery.
  • The long-term impact on bleb function at 24 months did not show a significant difference between the groups.
  • These findings suggest a potential short-term risk to trabeculectomy success when phacoemulsification is performed later.