Effect of phacoemulsification on trabeculectomy function

Nguyen, Dan Q; Niyadurupola, Nuwan; Tapp, Robyn J.; O'Connell, Rachael A; Coote, Michael; Crowston, Jonathan G

doi:10.1111/ceo.12254

Cited by 36 publications

(26 citation statements)

References 34 publications

(72 reference statements)

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“…Other studies have reported, after 2 years of follow-up, a failure (with need of topical medical therapy) in 29-45% of the eyes treated by a TE without AM, [2][3][4][5][6][7] and in 18-24% of eyes that had received a TE with AM. In controls, after TE with AM, a failure was found in 4-7% of the eyes (Table 3).…”

Section: Discussionmentioning

confidence: 96%

“…[1][2][3][4][5][6] However, a study showed that the rate of failure of TE after cataract surgery is not different from the natural course of TE. 7 The use of antimetabolites (AM) during TE reduced the failure rate; [8][9][10] also, the time between TE and cataract surgery 10,11 and baseline IOP 7 have been identified as factors affecting the outcome.…”

Section: Introductionmentioning

confidence: 99%

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Long-term effect of phacoemulsification on trabeculectomy function

Longo

Uva

Reibaldí

et al. 2015

Eye

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Purpose To investigate the long-term effect of phacoemulsification on intraocular pressure (IOP) in trabeculectomized eyes and to identify the factors affecting the IOP changes. Methods In consecutive patients with previous trabeculectomy (TE) who underwent uncomplicated clear cornea phacoemulsification we evaluated intraocular pressure, need of antiglaucomatous medical therapy or glaucoma surgery, and length of glaucoma control without therapy. Glaucoma therapy was prescribed in the presence of IOP 418 mm Hg or worsening of the visual field. A group of trabeculectomized eyes that did not receive cataract surgery was retrospectively selected as a control. Multivariate analysis was used to test factors related to final outcome of the treatment. Results One hundred and eight eyes with previous TE that received phacoemulsification and 108 controls were included in the study. Phacoemulsification was performed 60 ± 21 months after TE. After a mean follow-up of 66 ± 28 months, mean IOP was significantly increased in the cataract surgery group (by 1.7 ± 4.3 mm Hg) and in the control group (by 2.3 ± 4.3 mm Hg)(both Po0.001); in two groups, respectively, 31 eyes (28.7%) and 17 eyes (15.7%) had received glaucoma therapy (chi-square P = 0.030). Factors related to success (no need of therapy) were use of mitomycin-C (MMC) in previous TE (Po0.001), longer time from TE to cataract surgery (P = 0.007), higher preoperative bleb score (P = 0.021), and lower baseline IOP (P = 0.042). Conclusions Cataract surgery reduces the function of filtering bleb in some eyes. Factors related to low rate of failure are the previous use of MMC during TE, longer time from TE to cataract surgery, and good preoperative aspect of the bleb.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Long-term effect of phacoemulsification on trabeculectomy function

Longo

Uva

Reibaldí

et al. 2015

Eye

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“…Trabeculectomy alone in these eyes has the disadvantage that future cataract extraction may result in loss of the functioning filter. 37,38 Nevertheless, trabeculectomy has a role in PACG eyes that have already undergone phacoemulsification and in eyes with clear lens. In the presence of a visually significant cataract, the surgical options to consider are phacoemulsification alone or combined phacotrabeculectomy.…”

Section: Combined Phacoemulsification and Trabeculectomy (Phacotrabecmentioning

confidence: 99%

Management of Primary Angle-Closure Glaucoma

Lai,

Choy,

Shum

2016

Asia-Pacific Journal of Ophthalmology

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Primary angle-closure glaucoma (PACG) is a progressive optic nerve degeneration and is defined as a glaucomatous optic neuropathy with associated characteristic enlargement of optic disc cupping and visual field loss that is secondary to ocular hypertension caused by closure of the drainage angle. Angle closure is caused by appositional approximation or adhesion between the iris and the trabecular meshwork. The main treatment strategy for PACG lies in the reduction of intraocular pressure, reopening of the closed angle, and possible prevention of further angle closure. There is no universally agreed best surgical treatment for PACG. Trabeculectomy, goniosynechialysis (GSL), glaucoma implant, and cyclodestructive procedures are effective surgical options. Each of them plays an important role in the management of PACG with its own pros and cons. Accumulating evidence is available to show the effectiveness of visually significant and visually nonsignificant cataract extraction in the treatment of PACG. Trabeculectomy and GSL are often combined with cataract extraction, which may offer additional pressure control benefits to patients with PACG. This review article will discuss laser peripheral iridotomy, argon laser peripheral iridoplasty, and surgeries such as GSL, phacoemulsification, and phaco plus glaucoma surgeries that lower intraocular pressure and also alter the anterior segment and/or drainage angle anatomy. Currently, glaucoma implants and cyclodestruction are mainly reserved for PACG patients who have failed previous filtering operations. Their role as initial surgical treatment for PACG will not be discussed.

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“…In a retrospective study done by Nguyen et al [26] they found that phacoemulsification performed after trabeculectomy significantly increased rates of bleb failure in the following 12 months, but not at 24 months.…”

Section: Discussionmentioning

confidence: 99%

Effect of different incision sites of phacoemulsification on trabeculectomy bleb function: prospective case-control study

Anbar

Ammar

2017

BMC Ophthalmol

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BackgroundThe aim of this study was to compare superior and temporal clear corneal incisions of uneventful phacoemulsification and in-the-bag intraocular lens implantation on intraocular pressure control and the bleb morphology in eyes that have undergone previous successful trabeculectomy.MethodsIn this Prospective case-control study, a total of 100 eyes of 100 patients previously undergone trabeculectomy without antimetabolites, divided into two groups. Group A (temporal group) including 50 patients underwent phacoemulsification with a temporal corneal incision and group B (superior group) including 50 patients underwent phacoemulsification with a superior corneal incision. Comparisons between the two groups were performed after one year of follow-up regarding Intraocular pressure changes, bleb morphology score using the Wuerzburg bleb classification score and any added glaucoma medications.ResultsAt the last visit, the mean intraocular pressure for the temporal group was 17.55 ± 1.47 (p = 0.51) and for the superior group was 16.90 ± 1.71 (p = 0.85); the difference between the two groups was insignificant (p = 0.21). Regarding the bleb morphology, the mean bleb morphology score in the temporal group was 10.50 ± 0.95 (p = 0.19) and for the superior group was 10.20 ± 1.06 (p = 0.01).There was an insignificant difference in the bleb grading morphology regarding both groups (p = 0.35).ConclusionOur study demonstrates that phacoemulsification whether done with a clear temporal or clear superior wound, does not affect intraocular pressure, bleb morphology or function after one year of follow-up in eyes following previous successful trabeculectomy. Furthermore, cataract surgery may be performed safely in eyes with functioning filtering blebs.Trial registration ISRCTN91835217 ‘retrospectively registered’ Date Of registration 6/6/2017

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Effect of phacoemulsification on trabeculectomy function

Abstract: Phacoemulsification performed after trabeculectomy significantly increased rates of bleb failure in the following 12 months but not at 24 months.

Cited by 36 publications

References 34 publications

Long-term effect of phacoemulsification on trabeculectomy function

Long-term effect of phacoemulsification on trabeculectomy function

Management of Primary Angle-Closure Glaucoma

Effect of different incision sites of phacoemulsification on trabeculectomy bleb function: prospective case-control study

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