gms | German Medical Science

To evaluate the outcome of phacoemulsification in eyes after filtering glaucoma surgery.

Thirty eyes of 30 patients with different forms of glaucoma were included in this retrospective study. Intraocular pressure (IOP) was measured before and 1 week, 1, 3, 6, 12, 18, 24, 30, 36 and 42 months after phacoemulsification. The best corrected visual acuity (BCVA) and the number of antiglaucoma medications before phacoemulsification and at the end of follow-up were evaluated. Partial failure of IOP control was defined as the need for an increased number of antiglaucoma medications to maintain IOP < 21 mmHg. Complete failure of IOP control was defined as an IOP > 21 mmHg with an additional number of antiglaucoma medications and the need for filtration surgery.

The mean interval between filtration surgery and phacoemulsification was 5.8 years (SD 3.8) and the mean follow-up after phacoemulsification was 23.4 months (SD 11.4). There were no differences between the mean IOP before and after phacoemulsification during the entire follow-up period (p>0.05). The mean preoperative BCVA was 0.30 (SD 0.2), improving to a mean of 0.72 (SD 0.3) postoperatively at the end of follow-up (p<0.0001). The mean number of antiglaucoma medications before phacoemulsification was 1.2 (SD 1.2), increasing after phacoemulsification to 1.5 (SD 1.2) at the end of follow-up (p>0.05). In 9 eyes a partial failure of IOP control was assessed, so according to the Kaplan-Meier survival analysis the success rate after 12 months was 72% and after 42 months 67%. In 3 eyes a complete failure of IOP control was assessed, thus according to the Kaplan-Meier survival analysis the success rate after 22 months was 93% and after 42 months 77%.

Phacoemulsification in eyes after filtering glaucoma surgery was followed by a stable IOP, with a non-significant increase in the number of antiglaucoma medications and a significantly improved BCVA.