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Temporal corneal phacoemulsification in filtered glaucoma patients
J Caprioli1, H J Park, Y H Kwon
1Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA.
Purpose:
To evaluate the effect of temporal clear corneal phacoemulsification on intraocular pressure (IOP) in eyes that had prior trabeculectomy.
Design:
Retrospective case-control study.
Patients:
Forty consecutive patients (cases; TRAB-PHACO group) who underwent temporal corneal phacoemulsification subsequent to trabeculectomy were identified. Forty patients (controls; TRAB group) who had trabeculectomy alone were matched to the cases for length of follow-up, age, IOP, number of anti-glaucoma medications, number of 5-fluorouracil (5-FU) injections, race, sex and diagnosis.
Main Outcome Measures:
Comparison of IOP before and one year after phacoemulsification in the TRAB-PHACO group, and comparison with the TRAB group. Survival analysis of IOP control after trabeculectomy in the TRAB-PHACO and TRAB groups.
Results:
In the TRAB-PHACO group, IOP one year after phacoemulsification was not significantly different from the pre-phacoemulsification IOP value (p = 0.65). Kaplan-Meier survival analysis showed that the rates of IOP control at 3, 6 and 9 years after trabeculectomy in the TRAB-PHACO group were 80%, 66% and 44%; in the TRAB group these were 79%, 69% and 55%. These survival curves were not statistically different (p = 0.55).
Conclusions:
Cataract surgery by temporal clear corneal phacoemulsification in eyes with filtering blebs after trabeculectomy does not adversely affect long term IOP control.