Titre du document / Document title

The outcome of the functioning filter after subsequent cataract extraction

Auteur(s) / Author(s)

HALIKIOPOULOS Demetrios ⁽¹⁾ ; MOSTER Marlene R. ⁽¹⁾ ; AZUARA-BLANCO Augusto ⁽¹⁾ ; WILSON Richard P. ⁽¹⁾ ; SCHMIDT Courtland M. ⁽¹⁾ ; SPAETH George L. ⁽¹⁾ ; KATZ L. Jay ⁽¹⁾ ; AUGSBURGER James J. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Glaucoma Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania, ETATS-UNIS

Résumé / Abstract

■ OBJECTIVE: To evaluate and compare the outcome of functioning filtration surgery followed by cataract surgery with posterior intraocular lens implantation by both phacoemulsification and extra-capsular cataract extraction (ECCE) techniques in glaucomatous eyes. ■ PATIENTS AND METHODS: We retrospectively evaluated the clinical course of 77 eyes (68 patients) that after successful trabeculectomy, underwent cataract surgery by either phacoemulsification or ECCE techniques. We determined the frequency of partial and absolute failure following cataract surgery by either phacoemulsification or ECCE in eyes with functioning trabeculectomies. Partial failure of intraocular pressure (IOP), control after cataract extraction was defined as the need for an increased number of antiglaucoma medications or argon laser trabeculoplasty to maintain IOP <21mm Hg. Complete failure of IOP control after cataract surgery was defined as an IOP >21 mm Hg on at least two consecutive measurements one or more weeks apart or the performance of additional filtration surgery. Failure rates were calculated using the Kaplan-Meier actuarial method. Failure rates between phacoemulsification and ECCE subgroups were compared using the log rank test. ■ RESULTS: The probability of partial failure by the third postoperative year after cataract surgery was 39.5% in the phacoemulsification subgroup and 37.3% in the ECCE subgroup. This small difference is not statistically significant (P= 0.48). The probability of complete failure by the fourth postoperative year after cataract surgery was 12.0% in the phacoemulsification subgroup and 12.5% in the ECCE subgroup. This difference is also not statistically significant (P = 0.77). At the 6-month follow-up visit, visual acuity of both groups improved one or more lines in 87.0% of patients, and worsened one or more lines in 3.9% of patients. Sixty-one percent achieved visual acuity of 20/40 or better. The most frequent complication was posterior capsular opacification requiring laser capsulotomy that occurred in 31.2% of patients. ■ CONCLUSION: Cataract extraction by either phacoemulsification or ECCE following trabeculectomy surgery may be associated with a partial loss of the previously functioning filter and the need for more antiglaucoma medications to control IOP.

Revue / Journal Title

Ophthalmic surgery and lasers   ISSN 1082-3069   CODEN OSLAF2 

Source / Source

Congrès
American Academy of Ophtalmology Centennial Meeting, Chicago, Illinois , ETATS-UNIS (10/1996)
2001, vol. 32, n^o2, pp. 108-117 (16 ref.)

Langue / Language

Anglais

Editeur / Publisher

Slack, Thorofare, NJ, ETATS-UNIS  (1995-2000) (Revue)

Mots-clés anglais / English Keywords

Glaucoma (eye) ; Retrospective ; Treatment ; Trabeculectomy ; Combined surgery ; Association ; Cataract ; Extraction ; Lens ; Extracapsular ; Intraocular lens ; Implantation ; Posterior chamber ; Prognosis ; Human ; Eye disease ; Surgery ; Lens disease ; Anterior segment disease ;

Mots-clés français / French Keywords

Glaucome ; Rétrospective ; Traitement ; Trabéculectomie ; Chirurgie combinée ; Association ; Cataracte ; Extraction ; Cristallin ; Extracapsulaire ; Lentille intraoculaire ; Implantation ; Chambre postérieure ; Pronostic ; Homme ; Oeil pathologie ; Chirurgie ; Cristallin pathologie ; Segment antérieur pathologie ;

Mots-clés espagnols / Spanish Keywords

Glaucoma (ojo) ; Retrospectiva ; Tratamiento ; Trabeculectomía ; Cirugía combinada ; Asociación ; Catarata ; Extracción ; Cristalino ; Extracapsular ; Lente intraocular ; Implantación ; Cámara posterior ; Pronóstico ; Hombre ; Ojo patología ; Cirugía ; Cristalino patología ; Segmento anterior patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 14946, 35400009872400.0030