title: Factors correlating with failure to control intraocular pressure in primary angle-closure glaucoma eyes with coexisting cataract treated by phacoemulsification or combined phacotrabeculectomy.
abstract: OBJECTIVE
  To identify clinical factors correlating with failure to control intraocular pressure (IOP) in primary angle-closure glaucoma (PACG) eyes with cataract after phacoemulsification or phacotrabeculectomy.
  
  
  METHODS
  Retrospective analysis of two prospective randomized controlled clinical trials.
  
  
  METHODS
  Primary angle-closure glaucoma eyes with cataract received phacoemulsification or phacotrabeculectomy. Failure was defined as having IOP of 21mm Hg or greater, or requiring glaucoma drugs to maintain an IOP of less than 21 mm Hg, or having had additional IOP-lowering surgery. Factors correlating with failure at 24 months after surgery were identified using logistic regression model.
  
  
  RESULTS
  One hundred twenty-three PACG eyes with cataract and receiving phacoemulsification (n = 62) and phacotrabeculectomy (n = 61) were analyzed. With univariate analysis, factors associated with failure included a higher preoperative IOP, a higher preoperative requirement for glaucoma drugs, absence of plateau iris configuration, and phacoemulsification alone. With multivariate analysis, factors associated with failure included a higher preoperative IOP [odds ratio (OR), 1.732 per increase in IOP of 5 mm Hg], a higher preoperative requirement for glaucoma drugs (OR, 1.913), and performance of phacoemulsification alone (OR, 10.24).
  
  
  CONCLUSIONS
  In PACG eyes with cataract, higher preoperative IOP and increased requirement for glaucoma drugs correlate with failure to control IOP after phacoemulsification or phacotrabeculectomy. Phacotrabeculectomy is more likely than phacoemulsification to achieve IOP control.
authors.affiliation: From the *Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong; †Hong Kong Eye Hospital, Kowloon; ‡Prince of Wales Hospital, Shatin; and §Department of Ophthalmology, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong SAR, People's Republic of China.
authors.forename: Clement C Y
authors.initials: CC
authors.lastname: Tham
authors.forename: Dexter Y L
authors.initials: DY
authors.lastname: Leung
authors.forename: Yolanda Y Y
authors.initials: YY
authors.lastname: Kwong
authors.forename: Yuanbo
authors.initials: Y
authors.lastname: Liang
authors.forename: Andrea Yi
authors.initials: AY
authors.lastname: Peng
authors.forename: Felix C H
authors.initials: FC
authors.lastname: Li
authors.forename: Jimmy S M
authors.initials: JS
authors.lastname: Lai
authors.forename: Dennis S C
authors.initials: DS
authors.lastname: Lam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000627:therapeutic use; D002386:Cataract / Q000150:complications / Q000503:physiopathology; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D018918:Phacoemulsification; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin