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Impact of phacoemulsification on postoperative IOP after MMC trabeculectomy for uveitic glaucoma

Poster Details

First Author: K.Iwao JAPAN

Co Author(s):    A. Nishizawa   T. Inoue   H. Tanihara              

Abstract Details

Purpose:

To elucidate the frequency of additional cataract surgery and post-phacoemulsification IOP maintenance in uveitic glaucoma (UG) eyes with MMC trabeculectomy.

Setting:

A retrospective, comparative cohort study.

Methods:

Our study was conducted with phakic 264 patients who underwent trabeculectomy with MMC between 1996 and 2013 at Kumamoto University Hospital. The study group included 86 eyes with UG and 178 eyes with open-angle glaucoma (OAG; primary open-angle glaucoma and exfoliation glaucoma). Primary outcome measures included comparisons of the frequency of additional cataract surgery between UG and OAG eyes. Surgical failure after additional cataract surgery was defined as intraocular pressure levels of 21mm Hg (Criterion A) and 18mm Hg (Criterion B), or an additional glaucoma surgery. Kaplan-Meier survival curves for surgical failure were compared between UG and OAG eyes.

Results:

The mean follow-up periods (±SD) were 1635.9 ± 1446.6 and 1110.6 ± 977.0 days (median, 1269 and 936 days) for UG and POAG, respectively. UG eyes experienced more frequent cataract surgeries after trabeculectomy than OAG eyes: the 3-year probabilities of additional cataract surgery of 53.5 % and 34.6% for UG and POAG, respectively (P=0.003); despite the younger age in UG group (55.6 ± 15.2 vs 72.0 ± 6.5, p=0.0001). The 3-year probabilities of success post-phacoemulsification after trabeculectomy were 90.0% and 94.1% (p=0.869. criterion A), and 81.7% and 87.1% (p=0.869. criterion B) for UG and POAG, respectively.

Conclusions:

UG eyes after trabeculectomy with MMC more frequently required additional cataract surgery. However, post-phacoemulsification IOP level in UG eyes with trabeculectomy may be comparable to that in OAG group.

Financial Disclosure:

NONE

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