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. 2005 May;89(5):597-601.
doi: 10.1136/bjo.2004.041988.

Filtering bleb function after clear cornea phacoemulsification: a prospective study

J Klink  1 , B Schmitz, W E Lieb, T Klink, H-J Grein, J Sold-Darseff, A Heinold, F Grehn
Affiliations

Filtering bleb function after clear cornea phacoemulsification: a prospective study

J Klink et al. Br J Ophthalmol. 2005 May.

Abstract

Aim: To evaluate the influence of clear cornea phacoemulsification on filtering bleb morphology, function, and intraocular pressure (IOP) in glaucomatous eyes with previously successful filtering surgery.

Methods: The clinical course of 30 patients (30 eyes) who underwent clear cornea phacoemulsification after successful filtering glaucoma surgery was prospectively evaluated. Mean IOP and filtering bleb morphology (standardised assessment criteria and score 0-12, 12 = optimum) were determined before surgery, and 3 days, 6 months, and 12 months after surgery. The control group consisted of 36 patients with glaucoma after clear cornea phacoemulsification without previous filtering surgery.

Results: Mean IOP increased after phacoemulsification by about 2 mm Hg (preoperatively 14.28 (SD 3.71) mm Hg, 12 months postoperatively 16.33 (3.31) mm Hg, p = 0.006). 15 patients (50%) showed an IOP increase of >2 mm Hg, 11 patients (36.7%) had no IOP difference (within 2 mm Hg), and in four patients (13.3%) IOP decreased >2 mm Hg. Mean score of filtering bleb morphology 1 year after surgery decreased from 9.5 to 9.0 (p = 0.154). In three of 30 preoperatively IOP regulated eyes the postoperative IOP was 21 mm Hg. The control group showed an average IOP decrease of 2.01 mm Hg (p = 0.014) 12 months after cataract surgery.

Conclusion: An increase in IOP was found 1 year after phacoemulsification in half of the filtered glaucomatous eyes. IOP in glaucomatous eyes without previous filtering surgery decreased in the same period. Cataract extraction using clear cornea phacoemulsification may be associated with a partial loss of the previously functioning filter and with an impairment of filtering bleb morphology.

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Figures

Figure 1
Figure 1
Mean intraocular pressure (IOP) of glaucomatous eyes with previous glaucoma surgery after phacoemulsification (bleb group). *Significant p<0.05.
Figure 2
Figure 2
Mean intraocular pressure (IOP) of glaucomatous eyes without previous glaucoma surgery after phacoemulsification (control group). *Significant p<0.05.
Figure 3
Figure 3
Scattergram of individual intraocular pressures (IOP) before and 12 months after phacoemulsification (bleb group).
Figure 4
Figure 4
Scattergram of individual intraocular pressures (IOP) before and 12 months after phacoemulsification (control group).
Figure 5
Figure 5
Mean intraocular pressure (A) versus mean bleb morphology score (B). *Significant p<0.05.
Figure 6
Figure 6
Mean score of individual filtering bleb parameters.
See this image and copyright information in PMC

References

    1. Chen PP, Weaver YK, Budenz DL, et al. Trabeculectomy function after cataract extraction. Ophthalmology 1998;105:1928–35. - PubMed
    1. Mills KB. Trabeculectomy: a retrospective long term follow up of 44 cases. Br J Ophthalmol 1981;65:790–5. - PMC - PubMed
    1. Rebolleda G, Munoz-Negrete FJ. Phacoemulsification in eyes with functioning filtering blebs: a prospective study. Ophthalmology 2002;109:2248–55. - PubMed
    1. Wygansky-Jaffe T, Barak A, Melamed S, et al. Intraocular pressure increments after cataract extraction in glaucomatous eyes with functioning filtering blebs. Ophthalmic Surg Lasers 1997;28:657–61. - PubMed
    1. Crichton ACS, Kirker AW. Intraocular pressure and medication control after clear cornea phacoemulsification and Acrysof posterior chamber intraocular lens implantation in patients with filtering blebs. J Glaucoma 2001;10:38–46. - PubMed

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