Cataract surgery after trabeculectomy.

BACKGROUND AND OBJECTIVE: To determine the effect of cataract surgery on glaucomatous eyes with good intraocular pressure (IOP) control after trabeculectomy. PATIENTS AND METHODS: Twenty-two eyes with functional blebs that underwent cataract extraction were retrospectively analyzed. RESULTS: The mean (+/- SD) preoperative IOP was 11.0 +/- 4.3 mm Hg. The mean (+/- SD) postoperative IOPs at 1, 2, 6, and 9 months were 15.5 +/- 4.9, 12.6 +/- 4.7, 14.6 +/- 5.6, and 19.0 +/- 7.9 mm Hg, respectively. At each interval except for the second month, the mean IOP was statistically significantly higher than the preoperative value (P = .0003, .24, .02, and .0009, respectively). The total number of medications was also higher (3 preoperatively versus 27 postoperatively). The interval between the two surgeries had no influence on IOP control. Intraoperative complications during cataract surgery, particularly vitreous loss, were associated with poor IOP control. Phacoemulsification had less of an effect on the postoperative IOP control than did extracapsular cataract extraction. CONCLUSIONS: Eyes with previous successful trabeculectomies had higher IOPs and required more medications after subsequent cataract surgeries.

Duke Scholars

Author Paul Pue-Jung Lee Ophthalmology, Glaucoma