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Glaucoma control after phacoemulsification in eyes with functioning glaucoma filtration surgeries: trabeculectomies versus glaucoma drainage devices

  • Glaucoma
  • Published:
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Abstract

Purpose

Several studies have demonstrated decompensation of intraocular pressure (IOP) control following phacoemulsification in eyes with a functioning trabeculectomy. Limited evidence base suggests that this effect is minimal in eyes with functioning glaucoma drainage devices (GDD). The aim of this study was to report on glaucoma control after phacoemulsification in eyes with a functioning GDD compared to eyes with a functioning trabeculectomy.

Methods

Single-centre retrospective comparative study of patients with a functioning non-valved GDD (Baerveldt 350; Johnson & Johnson Surgical Vision) or trabeculectomy undergoing phacoemulsification. Glaucoma outcomes including IOP, cup:disc ratio (CDR), global retinal nerve fibre layer (RNFL) thickness and visual field mean deviation (MD) are reported. Failure was defined as IOP rise > 20% from baseline.

Results

Fifteen eyes with a functioning trabeculectomy and twenty-three eyes with a functioning GDD with 24-month post-phacoemulsification data were identified. Mean IOPs were significantly lower in the trabeculectomy group at month 24 compared to the GDD group, 9.5 and 15.9 mmHg (p = 0.001) respectively. At month 12, there was significant worsening on MD in GDD group compared to trabeculectomy group, − 20.0 dB and − 11.3 dB respectively (p = 0.03). A greater proportion of eyes failed in the GDD group compared to the trabeculectomy group, N = 15 (65%) and n = 7 (47%), p = 0.26.

Conclusion

As with functioning trabeculectomies, phacoemulsification should be approached with similar caution in eyes with functioning GDD. An existing GDD is at least as likely to fail following clear corneal phacoemulsification as an existing trabeculectomy and non-augmented GDDs may be at greater risk.

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Author information

Author notes

  1. Maninee Purohit and Abhijit Anand Mohite contributed equally to this work.

Authors and Affiliations

  1. Birmingham and Midland Eye Centre, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK

    Maninee Purohit & Velota C. T. Sung

  2. New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton Rd, Heath Town, Wolverhampton, WV10 0QP, UK

    Maninee Purohit & Abhijit Anand Mohite

Authors
  1. Maninee Purohit
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  2. Abhijit Anand Mohite
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  3. Velota C. T. Sung
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Contributions

MP was responsible for study design, data collection, analysis, conducting a literature search and writing the manuscript. AAM was responsible for performing statistical tests including Kaplan–Meier analysis, writing the manuscript and literature search. VCTS was responsible for identifying suitable cases and provided feedback on proforma and on the manuscript.

Corresponding author

Correspondence to Velota C. T. Sung.

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This was a retrospective case note review. This article does not contain any studies with human participants performed by any of the authors.

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As this was a retrospective case review, it was registered within the local NHS Trust’s clinical governance department and informed consent was not required upon application.

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The authors declare no competing interests.

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Purohit, M., Mohite, A. & Sung, V. Glaucoma control after phacoemulsification in eyes with functioning glaucoma filtration surgeries: trabeculectomies versus glaucoma drainage devices. Graefes Arch Clin Exp Ophthalmol 260, 3597–3605 (2022). https://doi.org/10.1007/s00417-022-05680-z

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  • DOI: https://doi.org/10.1007/s00417-022-05680-z

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