Results of combined phacoemulsification and trabeculectomy with mitomycin C in pseudoexfoliation versus non-pseudoexfoliation glaucoma.
BACKGROUND
This study was conducted to evaluate the rate of intraoperative and postoperative complications and the outcome of combined phacoemulsification (phaco) with posterior chamber (PC) intraocular lens (IOL) and trabeculectomy in patients with pseudoexfoliation (PXF) versus non-pseudoexfoliation (non-PXF) glaucoma.


METHODS
One hundred and four eyes of 88 patients with combined phaco, PC IOL and trabeculectomy with mitomycin C (MMC) were included in the study. MMC 0.02% was applied for 1 min in all cases. Main outcome measures were rate of intraoperative and postoperative complications, intraocular pressure (IOP) and visual acuity (VA). Success rates were determined via Kaplan-Meier survival analysis. Surgical success for both groups was defined as IOP being less than 21 mmHg with no treatment or less than 16 with one topical pressure-reducing agent allowed.


RESULTS
The PXF group included 55 (52.9%) eyes and the non-PXF group 49 (47.1%) eyes. Transition to extracapsular cataract extraction (ECCE) occurred in 12.7% of the PXF group, and in 6.1% of the non-PXF group (P=0.16). The occurrence of vitreous loss did not differ significantly between the groups. Patients of both groups had a significant IOP reduction after surgery (P=0.0001). At the end of postoperative follow-up, the success rate approached 83.6% in the PXF group and 83.7% in the non-PXF group. The most common postoperative complications were hyphema (14.5%) in the PXF group and fibrin (14.3%) in the non-PXF group.


CONCLUSIONS
Although transition to ECCE was more frequent in the PXF than in the non-PXF group, there was no significant difference in the rate of complications between PXF and non-PXF eyes.
Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel. genal@inter.net.il
Gennady
G
Landa
Ayala
A
Pollack
Rony
R
Rachmiel
Amir
A
Bukelman
Arie
A
Marcovich
Miriam
M
Zalish
D000368:Aged; D002386:Cataract / Q000150:complications / Q000628:therapy*; D017889:Exfoliation Syndrome / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications / Q000517:prevention & control; D007432:Intraoperative Period; D019654:Lens Implantation, Intraocular; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use*; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome
D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin