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AGS 2014


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AGS 2014

  1. 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%