Comparison of long-term incidence of posterior capsular opacification between phacoemulsification and phacotrabeculectomy.
OBJECTIVE
To investigate the long-term incidence of posterior capsular opacification after phacoemulsification compared with phacotrabeculectomy with or without adjunctive subconjunctival mitomycin C.


METHODS
This was a retrospectively conducted long-term, observational, case-control study. One hundred eyes of 100 cataract patients who underwent phacoemulsification and posterior chamber intraocular lens implantation and 100 eyes of 100 primary open-angle glaucoma patients with cataract that underwent phacotrabeculectomy and posterior chamber intraocular lens implantation, matched with respect to age, intraocular lens type, prevalence of diabetes mellitus, and length of follow-up. The main outcome measure was the rate of clinically significant posterior capsular opacification as determined by slit-lamp biomicroscopy and necessity to perform neodynium:yttrium aluminum garnet (Nd:YAG) capsulotomy and as calculated by Kaplan-Meier survival analysis. Postoperative visual acuity and maintenance of intraocular pressure control were also measured.


RESULTS
There was no significant difference in the rate of posterior capsular opacification requiring Nd:YAG capsulotomy between the phacoemulsification and phacotrabeculectomy groups (P =.77). However, a significant difference in the rate of posterior capsular opacification was found between those patients without diabetes mellitus and those with a preoperative diagnosis of diabetes mellitus (P =.016). Also, survival analysis comparing use of mitomycin C with no use of mitomycin C in the phacotrabeculectomy group showed a higher survival in the mitomycin C subgroup (P =.03).


CONCLUSIONS
There was no significant difference in long-term posterior capsular opacification between phacoemulsification and phacotrabeculectomy in the study population. Intraoperative, adjunctive use of mitomycin C in the phacotrabeculectomy group and the presence of diabetes mellitus in the overall patients were beneficial (protective) factors against posterior capsular opacification.
Shin
Dong H
DH
Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan 48201-1423, USA. dongshin@med.wayne.edu
Vandenbelt
Scott M
SM
Kim
Paul H
PH
Gross
Jason P
JP
Keole
Nandita S
NS
Lee
Sang H
SH
Birt
Catherine M
CM
Reed
Steven Y
SY
D000368:Aged; D000963:Antimetabolites / Q000627:therapeutic use; D016022:Case-Control Studies; D002386:Cataract / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular; D008137:Longitudinal Studies; D008297:Male; D008824:Michigan / Q000453:epidemiology; D016685:Mitomycin / Q000627:therapeutic use; D018918:Phacoemulsification / Q000009:adverse effects*; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000009:adverse effects*; D014792:Visual Acuity
D000963:Antimetabolites; D016685:Mitomycin