title: Deterioration of filtering bleb morphology and function after phacoemulsification.
abstract: BACKGROUND
  Trabeculectomy remains the most efficient method of lowering he IOP applied for the treatment of glaucoma refractory to pharmacological treatment. Cataract is concerned as the most frequent late complication of trabeculectomy. The aim of the study was to analyse the effect of phacoemulsification with posterior chamber lens implantation on the morphology and function of filtering bleb in patients after previous successful trabeculectomy.
  
  
  METHODS
  The retrospective study included 122 eyes treated for primary open angle glaucoma, 50 eyes (study group) in which, after a successful trabeculectomy with 5-Fluorouracil, phacoemulsification with posterior chamber lens implantation was performed, and 72 eyes (control group), in which only a successful trabeculectomy was conducted. The surgical success of the trabeculectomy was expressed as IOP < 17 mmHg.
  
  
  RESULTS
  In the group of patients subjected to both trabeculectomy and phacoemulsification, mean IOP was significantly higher than in the group of patients who underwent trabeculectomy after 6 months (p = 0.003), 12 months (p = 0.01) and 18 months (p = 0.007) of observation. The filtering blebs after phacoemulsification in the study group were characterized by a greater reduction, compared to those in the control group. Cox regression survival success was 75% (SE = 5.9; 95% CI: 63.4-86.6), 75% (SE = 5.9; 95% CI: 63.4-86.6), 71% (SE = 5.4; 95% CI: 60.4-81.6) in study group and 92% (SE = 1.8; 95% CI: 91.5-98.5), 92% (SE = 1.9; 95% CI: 88.3-95.7), 91% (SE = 2.0; 95% CI: 87.1-94.9) in control group after 6, 12 and 18 months, respectively.
  
  
  CONCLUSIONS
  Phacoemulsification causes a significant elevation of IOP in the eyes after previous successful trabeculectomy and deterioration of filtering bleb morphology.
authors.affiliation: Chair of Ophthalmology, Medical University of Lublin, Chmielna Str No 1, 20-079 Lublin, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Sałaga-Pylak
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Kowal
authors.forename: Tomasz
authors.initials: T
authors.lastname: Zarnowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018463:Filtering Surgery; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D012044:Regression Analysis; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*