Results of phacoemulsification in eyes with preexisting glaucoma filters

Abstract

A retrospective analysis was performed on 58 eyes that had temporal phacoemulsification via a clear corneal (32 eyes) or scleral tunnel (26 eyes) approach after previous filtration surgery with a minimum follow-up of 12 months. The study analyzed best-corrected visual acuity (BCVA), changes in intraocular pressure (IOP), and changes in glaucoma medication requirements. There were no statistically significant differences between the two groups in BCVA, IOP, and postoperative glaucoma medication requirements or between patients who received mitomycin C at the time of the original filter and those who did not. The mean preoperative logarithm of the minimal angle of resolution (logMAR) equivalent BCVA for all eyes was 0.8 + 0.4, which improved to a mean of 0.4 + 0.4 postoperatively (P < .0000002). The mean preoperative IOP in all eyes was 11.8 + 4.2 mm Hg and the mean final postoperative IOP was 13. 7 + 4.6 mm Hg (P < .022). The mean preoperative number of glaucoma medications for all eyes was 0.6 + 1.1 and the mean final postoperative number of glaucoma medications was 0.5 + 0.9 (not significant). Clear corneal or scleral tunnel phacoemulsification in the setting of a preexisting glaucoma filter was associated with improved BCVA, a small but statistically significant increase in IOP, and stability in the number of glaucoma medications required for IOP control over a minimum follow-up of 1 year.—Michael D. Wagoner