J Korean Ophthalmol Soc.  2021 Mar;62(3):371-378. 10.3341/jkos.2021.62.3.371.

Comparison of Surgical Outcomes after Phacoemulsification between Trabeculectomized Eyes and Ahmed Valve-implanted Eyes

• Park GS
• Kim KN
• Park KS
• Lee HM
• Lee NH
• Kim Cs

• KMID: 2514252
• DOI: http://doi.org/10.3341/jkos.2021.62.3.371

Abstract

Purpose
We compared the outcomes of cataract surgery in patients who underwent trabeculectomy and Ahmed glaucoma valve implantation.
Methods
Twenty-nine trabeculectomized eyes of 29 patients (group 1) and 20 Ahmed glaucoma valve-implanted eyes of 20 patients (group 2) were enrolled consecutively. All subjects underwent thorough ophthalmic examinations, including slit-lamp microscopy and Goldmann applanation tonometry preoperatively, on postoperative days 1 and 7, and at postoperative months 1, 3, and 6. The surgical outcomes including intraocular pressure (IOP) and the required number of IOP-lowering medications were compared between the two groups.
Results
The mean preoperative IOP in groups 1 and 2 was 15.34 ± 4.34 and 16.35 ± 3.44 mmHg, respectively (p = 0.265). In group 1, the IOP on postoperative day 1 increased significantly (by 3.86 ± 9.69 mmHg, p = 0.038), and the number of IOP-lowering medications rose at both 3 months (0.28 ± 0.70, p = 0.046) and 6 months (0.34 ± 0.94, p = 0.047) postoperatively. Group 2 exhibited no change in the IOP postoperatively or the number of IOP-lowering medications required in the postoperative period. Subconjunctival 5-fluorouracil injections for IOP control were required by two group 1 patients within 1 month postoperatively.
Conclusions
In patients with a trabeculectomized eye, the IOP increased immediately after cataract surgery; additional IOP-lowering procedures were required by some patients. The number of IOP-lowering medications increased after 3 months postoperatively. As cataract surgery may compromise filtering bleb function to a greater extent in trabeculectomized than in Ahmed glaucoma valve-implanted eyes, the former eyes require closer observation during the early postoperative period.

Keyword

Glaucoma drainage implants, Phacoemulsification, Trabeculectomy