Abstract
Purpose:
Combined cataract/glaucoma surgery is indicated in eyes with cataract and a failed trabeculectomy. IOP control following a failed trabeculectomy may be achieved with a needling procedure or a repeat trabeculectomy. The purpose of this study was to compare the efficacy and safety of phacoemulsification and needling with mytomicin C (phaconeedling) or phacoemulsification and a second trabeculectomy with mytomicin C (phaco-retrabeculectomy) in patients with cataract and a failed trabeculectomy.
Methods:
A retrospective, nonrandomized and comparative study of 22 eyes of 22 patients who underwent phaconeedling (n=10) or phaco-retrabeculectomy (n=12). Postoperative outcome measures included change in visual acuity (VA), intraocular pressure (IOP), the number of antiglaucoma medications, and postoperative complications.
Results:
There were no differences in age, sex, ethnicity, type of glaucoma or number of previous glaucoma surgeries between the groups (p>0.05). Preoperatively, mean±SD logMAR VA (1.38±0.6 versus 1.22±0.7, p=0.94) and IOP (15.75±5.2 versus 16.84±6.8, p=0.66) were similar, but the number of anti-glaucoma medications was significantly higher for phaco-retrabeculectomy group (3.08±0.7 versus 3.81±0.7, p=0.03). Patients were followed for a mean of 6.18±4.3 months (range: 2 to 12 months). After 6 months, mean IOPs in the phaconeedling and phaco-retrabeculectomy were 9.66±3.5 mmHg and 14.77±6.83 mmHg, respectively (p=0.25), and the number of antiglaucoma medications were 0.33±0.5 and 1.00±1.3, respectively (p=0.42). There were no significant differences regarding postoperative complications between the groups (p=0.54).
Conclusions:
Phaconeedling is an effective and safe surgical option for eyes with cataract and a failed trabeculectomy.
Keywords: 568 intraocular pressure •
445 cataract •
462 clinical (human) or epidemiologic studies: outcomes/complications