title: Impact of phacoemulsification on failure of trabeculectomy with mitomycin-C.
abstract: OBJECTIVE
  To evaluate whether phacoemulsification after trabeculectomy affects postoperative intraocular pressure (IOP).
  
  
  METHODS
  Kumamoto University, Kumamoto, Japan.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  The medical records of patients with primary open-angle glaucoma or exfoliation glaucoma who had trabeculectomy with mitomycin-C were reviewed. The primary endpoints were condition A (persistent postoperative IOP 21 mm Hg or higher or additional glaucoma procedures with or without medications) and condition B (postoperative IOP 18 mm Hg or higher or additional glaucoma procedures with or without medications). Multivariable analysis was performed using the Cox proportional hazards model.
  
  
  RESULTS
  The records of 178 patients (178 eyes) were reviewed. The mean follow-up was 37.0 months. For condition A, the probability of treatment success at 1 year, 2 years, and 3 years was 97.9%, 95.0%, and 92.7%, respectively. For condition B, the corresponding probabilities of success were 92.3%, 84.1%, and 81.8%. Thirty-seven patients (37 eyes) had phacoemulsification after trabeculectomy; 10 of those patients had phacoemulsification within 1 year after trabeculectomy. Multivariate analysis showed that a higher IOP before trabeculectomy was a significant risk factor for condition A and condition B (P=.01 and P=.0006, respectively); phacoemulsification within 1 year after trabeculectomy was significantly associated with trabeculectomy failure for condition B (P=.04).
  
  
  CONCLUSIONS
  Postoperative IOP in eyes with previous trabeculectomy may be affected by the IOP before trabeculectomy and phacoemulsification within 1 year after trabeculectomy.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Department of Ophthalmology and Visual Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Nanako
authors.initials: N
authors.lastname: Awai-Kasaoka
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Inoue
authors.forename: Yuji
authors.initials: Y
authors.lastname: Takihara
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawaguchi
authors.forename: Masaru
authors.initials: M
authors.lastname: Inatani
authors.forename: Minako
authors.initials: M
authors.lastname: Ogata-Iwao
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Tanihara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage; D003131:Combined Modality Therapy; D017889:Exfoliation Syndrome / Q000601:surgery; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D018918:Phacoemulsification / Q000009:adverse effects*; D011182:Postoperative Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014130:Trabeculectomy; D017211:Treatment Failure
chemical_list: D000959:Antihypertensive Agents; D016685:Mitomycin