RISK-FACTORS FOR UNSATISFACTORY INTRAOCULAR-PRESSURE CONTROL IN COMBINED TRABECULECTOMY AND CATARACT-SURGERY

BACKGROUND AND OBJECTIVE: Trabeculectomy combined with posterior chamb er intraocular lens (PC IOL) insertion is often chosen for the treatme nt of glaucoma combined with cataract. In this study, the clinical pro gnostic indicators for late intraocular pressure (IOP) control in comb ined procedures were investigated. PATIENTS AND METHODS: The clinical records of 60 eyes that underwent trabeculectomy combined with PC IOL implantation were retrospectively analyzed using the Cox proportional hazards model. All of the patients received postoperative 5-fluorourac il injections. RESULTS: Extracapsular cataract extraction (ECCE) was f ound to be a statistically significant risk factor for unsatisfactory late IOP control (hazard ratio 2.54; P < .01) and for unsatisfactory f iltering bleb appearance (hazard ratio 5; P < .001). The frequency of fibrin formation and the incidence of a transient IOP spike (greater t han or equal to 25 mm Hg) were significantly lower in the phacoemulsif ication and aspiration (PEA) group than in the ECCE group. In the PEA group, the probability of IOP control (less than or equal to 15 mm Hg) without medication was 54%, and the probability of persistent filteri ng bleb appearance was 80% at 18 months. CONCLUSION: The PEA technique , not ECCE, should be employed in combined trabeculectomy and PC IOL i mplantation.