EARLY INTRAOCULAR-PRESSURE AFTER PHACOEMULSIFICATION COMBINED WITH TRABECULECTOMY

BACKGROUND AND OBJECTIVE: To determine the efficacy of combined phacoe mulsification-trabeculectomy in preventing early postoperative increas es in intraocular pressure (IOP). PATIENTS AND METHODS: Eighty patient s were enrolled in a prospective cohort study. Thirty-six patients wit h cataracts and uncontrolled glaucoma underwent combined phacoemulsifi cation-trabeculectomy, and 44 patients with cataracts underwent phacoe mulsification alone. The operations were performed in a standardized m anner by one surgeon. IOP-was measured at 4 hours, 1 day, and 7 days a fter surgery. The need for intervention (digital massage, medications) and the presence of complications were documented. RESULTS: Four hour s after surgery, 5.5% of patients undergoing the combined procedure ha d IOPs greater than 30 mm Hg, compared with 22.7% of phacoemulsificati on patients (P < .05). No significant difference in IOP was found betw een the groups at postoperative day 1 or day 7. CONCLUSION: These resu lts suggest that combined phacoemulsification-trabeculectomy protects against early postoperative elevations in IOP. This finding may influe nce the surgical management of cataracts in patients with poorly contr olled glaucoma and significant compromise of visual field or optic ner ve.