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November 1997

Temporal Corneal Phacoemulsification in Patients With Filtered Glaucoma

Author Affiliations

From the Glaucoma Section, Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Conn.

Arch Ophthalmol. 1997;115(11):1375-1380. doi:10.1001/archopht.1997.01100160545003

Objective:  To evaluate the effect of temporal clear corneal phacoemulsification on intraocular pressure (IOP) in eyes that underwent prior trabeculectomy.

Design:  Retrospective case-control study.

Patients:  Forty consecutive patients who underwent temporal clear corneal phacoemulsification subsequent to trabeculectomy (trabeculectomy-phacoemulsification group) were identified, and 40 control patients who underwent trabeculectomy alone (trabeculectomy group) were matched to the case patients for length of follow-up, age, IOP, number of antiglaucoma medications, number of 5-fluorouracil injections, race, sex, and diagnosis.

Main Outcome Measures:  Intraocular pressure before vs 1 year after phacoemulsification in the trabeculectomy-phacoemulsification group compared with IOP in the trabeculectomy group and survival analysis of IOP control after trabeculectomy in the 2 groups.

Results:  In the trabeculectomy-phacoemulsification group, IOP 1 year after phacoemulsification was not significantly different from the prephacoemulsification IOP value (P=.65). Kaplan-Meier survival analysis showed that the rates of IOP control 3, 6, and 9 years after trabeculectomy in the trabeculectomy-phacoemulsification group were 80%, 66%, and 44%, respectively; in the trabeculectomy group, these were 79%, 69%, and 55%, respectively. These survival curves were not statistically different (P=.55).

Conclusion:  Cataract surgery by temporal clear corneal phacoemulsification in eyes with filtering blebs after trabeculectomy does not adversely affect longterm IOP control.

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