[Long-term influence of pre-, intra-, and postoperative factors on the intraocular pressure in combined cataract and glaucoma surgery]

Abstract

Purpose: The aim of the study was to evaluate the long-term intraocular pressure (IOP)-lowering effect of combined cataract and glaucoma surgery and the influence of peri- and intraoperative factors upon it.

Method: In a prospective study 300 eyes received simultaneous phacoemulsification and covered goniotrephination at the same site. Intraoperative factors were monitored. Median follow-up was 24 months (8-45).

Results: At the last postoperative control the mean IOP was 15.4 mmHg (14.7 mmHg in pseudoexfoliation glaucoma, n=78). Compared to preoperative values 60.3% had a 20% reduction of IOP to a level below 21 mmHg without eye medication. There was no significant rise in IOP during the follow-up time (8th-45th month). Of no or minimal influence (pmax=0.01) were the intraoperative factors, the IOP at the end of surgery, and postoperative complications (fibrin 6%, choroidal detachment 3.3%, hypotony <7 mmHg 5.5%, and blood beneath the whole bleb 5%). Of significant influence were a long lasting glaucoma ( p=0.003) and the usage of IOP-lowering eyedrops ( p<0.0001).

Conclusion: Combined cataract and glaucoma surgery is a safe alternative to single glaucoma surgery with similar results. Intraoperative factors have minimal influence on the IOP-lowering effect.