TEMPORAL CORNEAL PHACOEMULSIFICATION IN PATIENTS WITH FILTERED GLAUCOMA

Objective: To evaluate the effect of temporal clear corneal phacoemuls ification on intraocular pressure (IOP) in eyes that underwent prior t rabeculectomy. Design: Retrospective case-control study. Patients: For ty consecutive patients who underwent temporal clear corneal phacoemul sification subsequent to trabeculectomy (trabeculectomy-phacoemulsific ation group) were identified, and 40 control patients who underwent tr abeculectomy alone (trabeculectomy group) were matched to the case pat ients for length of follow-up, age, IOP, number of antiglaucoma medica tions, number of 5-fluorouracil injections, race, sex, and diagnosis. Main Outcome Measures: Intraocular pressure before vs 1 year after pha coemulsification in the trabeculectomy-phacoemulsification group compa red with IOP in the trabeculectomy group and survival analysis of IOP control after trabeculectomy in the 2 groups. Results: In the trabecul ectomy-phacoemulsification group, IOP 1 year after phacoemulsification was not significantly different from the prephacoemulsification IOP v alue (P=.65). Kaplan-Meier survival analysis showed that the rates of IOP control 3, 6, and 9 years after trabeculectomy in the trabeculecto my-phacoemulsification group were 80%, 66%, and 44%, respectively; in the trabeculectomy group, these were 79%, 69%, and 55%, respectively. These survival curves were not statistically different (P=.55). Conclu sion: Cataract surgery by temporal clear corneal phacoemulsification i n eyes with filtering blebs after trabeculectomy does not adversely af fect long-term IOP control.