Effect of phacoemulsification surgery on hypotony following trabeculectomysurgery

Objective: To review the effect of phacoemulsification surgery in eyes with chronic hypotony following trabeculectomy with mitomycin C. Design: Retrospective analysis of all eyes that underwent phacoemulsificati on surgery for symptomatic cataracts and had a preoperative diagnosis of ch ronic hypotony (intraocular pressure [IOP] less than or equal to 6 mm Hg) f or at least 6 months following trabeculectomy with mitomycin C. Each case h ad at least 6 months' follow-up after the phacoemulsification surgery. Setting: A tertiary care referral center. Intervention: Clear cornea phacoemulsification surgery, with minimal periop erative anti-inflammatory medication and retention of viscoelastic in eyes at case conclusion. Main Outcome Measures: Intraocular pressure, visual acuity, and complicatio ns. Results: Nine eyes of 9 patients were identified. Mean preoperative IOP was 4.2 +/- 1.4 mm Hg; the mean postoperative IOP was 7.3 +/- 2.8 mm Hg (P = . 009). Intraocular pressure increased in all but 2 eyes. One of these 2 eyes experienced an acutely elevated IOP (34 mm Hg) on postoperative day 4, whi ch dropped back to preoperative levels after trabeculectomy flap needling. Mean preoperative visual acuity was 20/300; mean postoperative visual acuit y was 20/40. Conclusion: Phacoemulsification surgery may be associated with a statistica lly significant elevation in IOP in previously filtered eyes with hypotony, resulting in resolution of hypotony in some of these challenging cases.