Effect of prior phacoemulsification surgery in trabeculectomy surgery outcomes
Free Paper Details
First Author: S.Torres da Costa PORTUGAL
Co Author(s): A. Melo S. Estrela-Silva F. Falcão-Reis J. Barbosa Breda
To evaluate whether previous clear-cornea phacoemulsification affects the surgical outcomes of trabeculectomy in open angle glaucoma (OAG) patients.
Ophthalmology department of a tertiary center (Centro Hospitalar Universitário de São João, Porto, Portugal).
Retrospective cohort study comparing phakic and pseudophakic eyes at 1 and 2 years of follow-up. The primary outcome was the probability of surgical failure. Failure was defined as IOP superior than 21 mmHg or reduced less than 20% from baseline, IOP ≤ 5 mmHg, need for further glaucoma surgery, phthisis or loss of light perception vision due to glaucoma. Secondary outcome measures included: visual acuity, postoperative hypotensive medications, needling rate, intraoperative and postoperative complications and need for further glaucoma surgery. All trabeculectomy procedures were performed with adjunctive metabolites such as mitomycin C (0.2mg/mL) or 5-fluoracile (50 mg/ml).
In total, 87 eyes from 87 patients (63 phakic and 24 pseudophakic) were included. Pseudophakic group patients were significantly older than those in the phakic group, 76 vs 66 years (p=0,001). No other statistically significant differences between groups were found at baseline. The probability of surgical failure in the phakic vs pseudophakic group was 22% (12 in 54) vs 37% (7 in 19) at 1 year, and 22 % (11 in 50) vs 37,5% (6 in 16) at 2 years, respectively. No significant differences were detected in surgical failure rate at 1 (p=0,212) and 2 years (p=0,217).
Prior clear-cornea phacoemulsification may not significantly increase the rate of trabeculectomy failure.