Impact of phacoemulsification on failure of trabeculectomy with mitomycin-C.

Objective: To evaluate whether phacoemulsification after trabeculectomy affects postoperative intraocular pressure (IOP). Methods: Kumamoto University, Kumamoto, Japan. Methods: Cohort study. Methods: The medical records of patients with primary open-angle glaucoma or exfoliation glaucoma who had trabeculectomy with mitomycin-C were reviewed. The primary endpoints were condition A (persistent postoperative IOP 21 mm Hg or higher or additional glaucoma procedures with or without medications) and condition B (postoperative IOP 18 mm Hg or higher or additional glaucoma procedures with or without medications). Multivariable analysis was performed using the Cox proportional hazards model. Results: The records of 178 patients (178 eyes) were reviewed. The mean follow-up was 37.0 months. For condition A, the probability of treatment success at 1 year, 2 years, and 3 years was 97.9%, 95.0%, and 92.7%, respectively. For condition B, the corresponding probabilities of success were 92.3%, 84.1%, and 81.8%. Thirty-seven patients (37 eyes) had phacoemulsification after trabeculectomy; 10 of those patients had phacoemulsification within 1 year after trabeculectomy. Multivariate analysis showed that a higher IOP before trabeculectomy was a significant risk factor for condition A and condition B (P=.01 and P=.0006, respectively); phacoemulsification within 1 year after trabeculectomy was significantly associated with trabeculectomy failure for condition B (P=.04). Conclusions: Postoperative IOP in eyes with previous trabeculectomy may be affected by the IOP before trabeculectomy and phacoemulsification within 1 year after trabeculectomy.

Background: No author has a financial or proprietary interest in any material or method mentioned.