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Previous phaco increases risk of trabeculectomy failure
Arch Ophthalmol. 2011;129(2):152-157.
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Open-angle glaucoma patients who have previously undergone phacoemulsification are more likely to have surgical failure after trabeculectomy with mitomycin C, according to a study.
The retrospective, consecutive, comparative case series determined the probability of surgical success of 175 phakic eyes and 51 pseudophakic eyes undergoing initial trabeculectomy. Mean follow-up was 37.5 months.
Researchers defined surgical failure as the need for additional glaucoma surgery or IOP that was either 21 mm Hg or greater (criterion A), 18 mm Hg or greater (criterion B) or 15 mm Hg or greater (criterion C).
The probability of success was significantly lower in the pseudophakic group for criteria A (P < .001), B (P = .004) and C (P = .009), according to the study.
The pseudophakic group had undergone phacoemulsification with superior conjunctival incision prior to trabeculectomy and required more laser suture lysis after surgery (P = .01).
In addition, a multivariable model found that pseudophakia was an independent risk factor for trabeculectomy failure.
Further research is needed to determine the mechanism for trabeculectomy failure in these eyes.