Long-term effect of phacoemulsification on intraocular pressure after trabeculectomy.

摘要

PURPOSE: To evaluate the effect of temporal clear corneal phacoemulsification on intraocular pressure (IOP) in eyes that have had trabeculectomy. SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: This retrospective study evaluated the IOP in 48 eyes (35 patients) that had temporal clear corneal phacoemulsification after trabeculectomy. The mean interval between trabeculectomy and phacoemulsification was 27 months +/- 21 (SD) and the mean follow-up after phacoemulsification, 23 +/- 12 months. Intraocular pressure and antiglaucoma therapy before cataract surgery and at the end of follow-up were evaluated. For statistical analysis, the paired t test, Wilcoxon test, and chi-square test were used. RESULTS: Thirty-five eyes (73%) preoperatively and 25 eyes (52%) postoperatively were controlled (IOP < 22 mm Hg) without antiglaucoma therapy. The difference was statistically significant (P =.04, chi-square test). At the end of follow-up, the increase in mean IOP (1.6 mm Hg) and in mean number of antiglaucoma medications (0.4) was statistically significant (P =.002 and P =.05, respectively). CONCLUSIONS: Temporal clear corneal phacoemulsification after trabeculectomy was followed by a slight but statistically significant increase in IOP and the need for antiglaucoma medication after 2 years. However, the impairment in IOP control is comparable to that in the natural course of trabeculectomy.