Effect of phacoemulsification surgery on hypotony following trabeculectomy surgery.
OBJECTIVE
To review the effect of phacoemulsification surgery in eyes with chronic hypotony following trabeculectomy with mitomycin C.


METHODS
Retrospective analysis of all eyes that underwent phacoemulsification surgery for symptomatic cataracts and had a preoperative diagnosis of chronic hypotony (intraocular pressure [IOP] </=6 mm Hg) for at least 6 months following trabeculectomy with mitomycin C. Each case had at least 6 months' follow-up after the phacoemulsification surgery.


METHODS
A tertiary care referral center.


METHODS
Clear cornea phacoemulsification surgery, with minimal perioperative anti-inflammatory medication and retention of viscoelastic in eyes at case conclusion.


METHODS
Intraocular pressure, visual acuity, and complications.


RESULTS
Nine eyes of 9 patients were identified. Mean preoperative IOP was 4. 2 +/- 1.4 mm Hg; the mean postoperative IOP was 7.3 +/- 2.8 mm Hg (P=.009). Intraocular pressure increased in all but 2 eyes. One of these 2 eyes experienced an acutely elevated IOP (34 mm Hg) on postoperative day 4, which dropped back to preoperative levels after trabeculectomy flap needling. Mean preoperative visual acuity was 20/300; mean postoperative visual acuity was 20/40.


CONCLUSIONS
Phacoemulsification surgery may be associated with a statistically significant elevation in IOP in previously filtered eyes with hypotony, resulting in resolution of hypotony in some of these challenging cases. Arch Ophthalmol. 2000;118:763-765
Doyle
J W
JW
Department of Ophthalmology, JHMHC Box 100284, Gainesville, FL 32610-0284, USA. jwdoyle@eyel.eye.ufl.edu
Smith
M F
MF
D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications; D017024:Chemotherapy, Adjuvant; D002908:Chronic Disease; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D015814:Ocular Hypotension / Q000209:etiology / Q000503:physiopathology*; D018918:Phacoemulsification; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000009:adverse effects*; D014792:Visual Acuity
D016685:Mitomycin