Effect of phacoemulsification surgery on intraocular pressure and function of bleb after trabeculectomy

To evaluate the effect of phacoemulsification (PE) surgery on intraocular pressure (IOP) control and morphology of filtering bleb in eyes that have previously had trabeculectomy in the long-term.

This retrospective study included 98 eyes of 93 patients who had undergone trabeculectomy first and then PE surgery. The IOP, morphology of bleb, the number of glaucoma medication of each patient before PE, and 1 day, 1 month, 3 months, 1 year, 2 years after PE, and at the last visit were recorded. The need for additional glaucoma medication or glaucoma surgery were noted. Surgical success was defined as 6 mmHg ≤ IOP ≤ 21 mm Hg at the 3rd month, 1st year, and 2nd year follow-up visit, without additional medication or surgery.

Before PE the IOP was ≤ 21 mmHg in all of the eyes. At the last visit, the IOP was ≤ 21 mmHg in 6 eyes with fewer glaucoma medication, in 24 eyes with the same number, and in 36 eyes with more. There was an increase in the number of glaucoma medications on each visit (p < 0.05). There was a statistically significant difference in bleb morphologies between before PE and each visit after PE (p < 0.001). Surgical success after PE was obtained in 52 eyes, additional glaucoma medication was needed in 36 eyes, and additional surgical procedures were required in 14 eyes.

Phacoemulsification surgery may increase the number of glaucoma medications and the mean IOP and also may reduce the function of bleb in eyes that underwent trabeculectomy.