Posters

The effect of pseudophakia on trabeculectomy success

Poster Details

First Author: A.Liaska GREECE

Co Author(s):    D. Mitsiou   S. Stamelou   K. Andrianopoulou   D. Papantoniou           

Abstract Details

Purpose:

To determine whether previous phacoemulsification adversely affects surgical prognosis of trabeculectomy with 5-fluorouracil for open-angle glaucoma.

Setting:

Department of Ophthalmology, General Hospital of Lamia, Lamia, Greece

Methods:

retrospective chart review of 36 pseudophakic eyes(36 patients)that underwent primary trabeculectomy with 5-fluorouracil after clear-corneal phacoemulsification(temporal approach)between 2010 and 2018 in General Hospital of Lamia.The patients were compared to 48 phakic eyes(48controls) that underwent the same intervention at the same time period.All patients were operated by the same surgeon.All patients had preoperative IntraOcular Pressure(IOP))≥22mmHg mmHg under maximum tolerated glaucoma medication.Surgical success was defined as:(A)IOP≤18mmHg (B)IOP≤15mmHg and(C)IOP≤12mmHg with or without glaucoma medication.The main and secondary outcome measures were:success rates,IOP,number of medications at 1 and 2 years and visual acuity change,need for secondary intervention and visual field progression respectively.

Results:

The median (range) follow-up time was 34 months (6 to 80 mo) and 35 months (8 to 82 mo) in the pseudophakic and phakic groups, respectively. Success rates did not differ significantly between the 2 groups, however the pseudophakic group maintained lower IOPs after the first year. The number of medications necessary to maintain the target pressure was similar at both follow-up intervals in the 2 groups. 36 patients in the phakic group (36/48) required cataract operation within 2 years of glaucoma surgery.

Conclusions:

Primary trabeculectomy with 5-fluorouracil in eyes after clear corneal phacoemulsification was not inferior to primary trabeculectomy with 5-fluorouracil in phakic eyes at 2 years postoperatively. Clear-corneal phacoemulsification (temporal approach) does not seem to have adverse effect on the success of subsequent trabeculectomy. However, given the frequency of cataract operation after trabeculectomy, the effect of cataract operation on previous functioning trabeculectomy must be taken into account when performing trabeculectomy in phakic patients.

Financial Disclosure:

None