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. 2013 Apr 23:13:17.
doi: 10.1186/1471-2415-13-17.

Deterioration of filtering bleb morphology and function after phacoemulsification

Monika Sałaga-Pylak  1 , Małgorzata Kowal, Tomasz Zarnowski
Affiliations

Deterioration of filtering bleb morphology and function after phacoemulsification

Monika Sałaga-Pylak et al. BMC Ophthalmol. .

Abstract

Background: Trabeculectomy remains the most efficient method of lowering he IOP applied for the treatment of glaucoma refractory to pharmacological treatment. Cataract is concerned as the most frequent late complication of trabeculectomy. The aim of the study was to analyse the effect of phacoemulsification with posterior chamber lens implantation on the morphology and function of filtering bleb in patients after previous successful trabeculectomy.

Methods: The retrospective study included 122 eyes treated for primary open angle glaucoma, 50 eyes (study group) in which, after a successful trabeculectomy with 5-Fluorouracil, phacoemulsification with posterior chamber lens implantation was performed, and 72 eyes (control group), in which only a successful trabeculectomy was conducted. The surgical success of the trabeculectomy was expressed as IOP < 17 mmHg.

Results: In the group of patients subjected to both trabeculectomy and phacoemulsification, mean IOP was significantly higher than in the group of patients who underwent trabeculectomy after 6 months (p = 0.003), 12 months (p = 0.01) and 18 months (p = 0.007) of observation. The filtering blebs after phacoemulsification in the study group were characterized by a greater reduction, compared to those in the control group. Cox regression survival success was 75% (SE = 5.9; 95% CI: 63.4-86.6), 75% (SE = 5.9; 95% CI: 63.4-86.6), 71% (SE = 5.4; 95% CI: 60.4-81.6) in study group and 92% (SE = 1.8; 95% CI: 91.5-98.5), 92% (SE = 1.9; 95% CI: 88.3-95.7), 91% (SE = 2.0; 95% CI: 87.1-94.9) in control group after 6, 12 and 18 months, respectively.

Conclusions: Phacoemulsification causes a significant elevation of IOP in the eyes after previous successful trabeculectomy and deterioration of filtering bleb morphology.

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Figures

Figure 1
Figure 1
Correlation between IOP before and 18 months after phacoemulsification in the group of patients who previously underwent trabeculectomy (the Spearman’s correlation test).
Figure 2
Figure 2
A comparison of mean intraocular pressures in the study group and the control group (the U Mann–Whitney test).
Figure 3
Figure 3
Percentage of subjects from study group and control group with mean intraocular pressure change, obtained 18 months of observation beginning against the initial result.
Figure 4
Figure 4
Cox regression for surgical success of trabeculectomy in the study group.
See this image and copyright information in PMC

References

    1. Cairns JE. Trabeculectomy. Preliminary report of a new method. Am J Ophthalmol. 1968;66:673–679. - PubMed
    1. Derick RJ, Evans J, Baker ND. Combined phacoemulsification and trabeculectomy versus trabeculectomy alone: a comparison study using mitomycin-C. Ophthalmic Surg Lasers. 1998;29:707–713. - PubMed
    1. Friedman DS, Jampel HD, Lubomski LH. Surgical strategies for coexisting glaucoma and cataract: an evidence-based update. Ophthalmology. 2002;109:1902–1913. doi: 10.1016/S0161-6420(02)01267-8. - DOI - PubMed
    1. Yang KJ, Moster MR, Azuara-Blanco A, Wilson RP, Araujo SV, Schmidt CM. Mitomycin-C supplemented trabeculectomy, phacoemulsification, and foldable lens implantation. J Cataract Refract Surg. 1997;23:565–569. doi: 10.1016/S0886-3350(97)80215-5. - DOI - PubMed
    1. Fontana H, Nouri-Mahdavi K, Caprioli J. Trabeculectomy with mitomycin C in pseudophakic patients with open-angle glaucoma: outcomes and risk factors for failure. Am J Ophthalmol. 2006;141:652–659. doi: 10.1016/j.ajo.2005.11.039. - DOI - PubMed

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