[The effect of phacoemulsification on eyes with preexisting functional filtering blebs].
OBJECTIVE
To investigate the effect of clear corneal phacoemulsification on filtering bleb morphology and filtering function in glaucoma eyes with functional filtering blebs. Analysis the risk factors of intraocular pressure (IOP) increasement after phacoemulsification.


METHODS
It was a prospective series case study. Twenty-five eyes of 20 Chinese patients who had undergone clear corneal phacoemulsification after trabeculectomy were enrolled. IOP and the numbers of antiglaucoma medicine before and 1 month, 3 months, 6 months, 12 months and 24 months after phacoemulsification were recorded. Ultrasound Biomicroscopy was conducted preoperatively, 1 month and 24 months postoperatively. Compare the IOP and the numbers of antiglaucoma medicines before and after phacoemulsification by student t test. Risk factors were evaluated for association with loss of IOP control requiring additional medications or further glaucoma surgery, using Kaplan-Meier survival analysis.


RESULTS
The IOP was (15.8 +/- 5.1) mm Hg (1 mm Hg = 0.133 kPa), (13.7 +/- 3.6) mm Hg, (13.6 +/- 3.3) mm Hg, (14.4 +/- 4.1) mm Hg, (14.2 +/- 3.6) mm Hg, (13.8 +/- 3.5) mm Hg (P = 0.007, 0.004, 0.021, 0.033, 0.004) before and at 1, 3, 6, 12, 24 months after phacoemulsification. The numbers of antiglaucoma medicine were 0.2 +/- 0.6 and 0.3 +/- 0.7 before and after phacoemulsification (P = 0.265). Log-rank analysis the risk factors include IOP higher than 15 mm Hg before phacoemusification (P = 0.042), bleb height decreased more than 10% 1 month after phacoemusification (P = 0.037) and the intrableb reflectivity increase (P = 0.001).


CONCLUSIONS
Phacoemulsification on eyes with functional filtering bleb did not affect the filtering function. Risk factors of loss of IOP control include IOP higher than 15 mm Hg before phacoemusification, bleb height decreased more than 10% and the intrableb reflectivity increase in a short term after phacoemusification.
Peking University Third Hospital, Peking University Eye Center, Beijing 100083, China.
Ying
Y
Hong
Chun
C
Zhang
Wei
W
Wang
D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011446:Prospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome