1. Trabeculectomy with Mitomycin for Open-Angle Glaucoma in Phakic
versus Pseudophakic Eyes After Clear-Corneal Phacoemulsification
H. George Tanaka, M.D. and Edie De Niro, M.D., California Pacific Medical Center, San Francisco CA
Research Question
Methods
•Retrospective Cohort Study
•Patients with open-angle glaucoma
who underwent trabeculectomy
between 1992 and 2012
•Study Group: 63 eyes (57 patients)
with history of uncomplicated
temporal clear corneal
phacoemulsification before
trabeculectomy
•Control Group: 108 eyes (81 patients)
with no history of eye surgery before
trabeculectomy
•Inclusion criteria: Pre-trabeculectomy
IOP ≥ 18 mmHg and ≤ 40 mmHg. No
uveitis or neovascular glaucoma.
•Trabeculectomy was fornix-based,
suture-lysis was used, and mitomycin
C dose varied with surgeon
Outcome Measure
Trabeculectomy Failure, defined as:
1. IOP ≥ 21 mm Hg or not reduced
by 20% below baseline on 2
consecutive follow-up visits
after 3 months
2. IOP ≤ 5 mm Hg on 2
consecutive follow-up visits
after 3 months
3. Reoperation for glaucoma
4. Loss of light-perception vision
Results
31.7%
Results
Does clear-corneal phacoemulsification
affect subsequent trabeculectomy?
P =
0.107
Kaplan Meier Analysis
Months of Follow-up
(mean 13.4 months)
Green = Pseudophakic Eyes
Blue = Control Eyes
Conclusions
Clear corneal phacoemulsification
does not appear to adversely impact
subsequent trabeculectomy. Study
limitations include relatively small
sample size, retrospective
methodology and limited follow-up
time.
0
10
20
30
40
50
Pseudophakic
Eyes
Control Eyes (no
previous
surgery)
Percentage failing
n = 63 n = 108
42.6%