title: Surgical outcome after early intraocular pressure elevation following combined cataract extraction and trabeculectomy.
abstract: OBJECTIVE
  We report on the incidence and course of early postoperative intraocular pressure (IOP) elevation and related surgical outcome following combined manual extracapsular cataract extraction (ECCE), using a sclerocorneal tunnel incision and trabeculectomy.
  
  
  METHODS
  The combined procedure was the initial surgery in each eye. Intraocular pressure was measured during the first 4 days, at 1 week, and thereafter following surgery.
  
  
  RESULTS
  Of 38 eyes (38 consecutive adults), postoperative IOP elevation to > 25 mm Hg was found in 7 eyes (18.4%) during the first 3 postoperative days. The IOP was reduced to < or = 20 mm Hg without hypotensive medication in 3 of them within the first 3-7 postoperative days, and remained so after 7-16 months (mean, 10.3 +/- 4.9 months). Each of the other 4 eyes underwent argon-laser suture lysis 8-10 days after surgery due to unstable IOP which rose to > 30 mm Hg. Two weeks after the operation and thereafter, ie, after 8-22 months (mean, 12.8 +/- 6.4 months), each of these 4 eyes necessitated 1-4 (mean, 2.5 +/- 1.3) hypotensive medications.
  
  
  CONCLUSIONS
  This study raises the possibility that in eyes with early IOP elevation, a delay in promoting aqueous outflow beyond a critical period during the first postoperative week might become a risk factor for full surgical success.
authors.affiliation: Department of Ophthalmology, Hillel-Yaffe Medical Center, Hadera, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Porges
authors.forename: A
authors.initials: A
authors.lastname: Ophir
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications; D002387:Cataract Extraction / Q000009:adverse effects*; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000601:surgery; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D014130:Trabeculectomy / Q000009:adverse effects*; D016896:Treatment Outcome