title: Effect of temporal corneal phacoemulsification on intraocular pressure in eyes with prior trabeculectomy with an antimetabolite.
abstract: OBJECTIVE
  To evaluate the effect of temporal corneal phacoemulsification on intraocular pressure (IOP) in eyes after primary trabeculectomy with intraoperative fluorouracil (5-FU) or mitomycin C (MMC).
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  Twenty-nine patients who were participants in a prospective randomized double-masked trial comparing the efficacies of intraoperative 5-FU and MMC and who underwent temporal corneal phacoemulsification after the primary trabeculectomy were matched to 29 patients enrolled in the same study who did not undergo cataract surgery. The 2 groups were matched for length of follow-up after the trabeculectomy and the antimetabolite used at the time of trabeculectomy.
  
  
  METHODS
  Comparisons of IOP, visual acuity (VA), and the number of glaucoma medications were made between the 2 groups and within the groups at various follow-up intervals to detect any statistically significant differences.
  
  
  METHODS
  Intraocular pressure before phacoemulsification and at various times postoperatively were compared with IOP in the control group at the matched follow-up times.
  
  
  RESULTS
  The mean of all IOP measurements beyond 3 months after phacoemulsification for each subject was significantly higher than the prephacoemulsification IOP (11.8+/-4.2 vs. 8.7+/-4.5 mmHg; P = 0.00003, paired t test). In contrast, the mean IOP remained stable in the control group during the equivalent time period (9.6+/-3.5 vs. 9.1+/-3.1 mmHg; P = 0.42, paired t test). Postphacoemulsification IOP was significantly higher than the corresponding IOP in the time-matched control group (P<0.003, analysis of covariance). Mean VA improved significantly after the phacoemulsification (P = 0.0002) but remained stable in the control group.
  
  
  CONCLUSIONS
  Temporal corneal phacoemulsification can affect long-term IOP control after trabeculectomy with 5-FU or MMC.
authors.affiliation: Department of Ophthalmology, Indiana University, 702 Rotary Circle, Indianapolis, IN 46202, USA.
authors.forename: Kala
authors.initials: K
authors.lastname: Swamynathan
authors.forename: Angelita P
authors.initials: AP
authors.lastname: Capistrano
authors.forename: Louis B
authors.initials: LB
authors.lastname: Cantor
authors.forename: Darrell
authors.initials: D
authors.lastname: WuDunn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000963:Antimetabolites / Q000008:administration & dosage; D016022:Case-Control Studies; D003315:Cornea / Q000601:surgery*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D018918:Phacoemulsification / Q000379:methods*; D011897:Random Allocation; D012189:Retrospective Studies; D014130:Trabeculectomy; D014792:Visual Acuity
chemical_list: D000963:Antimetabolites; D016685:Mitomycin; D005472:Fluorouracil