Effect of phacoemulsification surgery on hypotony following trabeculectomy surgery.

OBJECTIVE

To review the effect of phacoemulsification surgery in eyes with chronic hypotony following trabeculectomy with mitomycin C.

DESIGN

Retrospective analysis of all eyes that underwent phacoemulsification surgery for symptomatic cataracts and had a preoperative diagnosis of chronic hypotony (intraocular pressure [IOP] </=6 mm Hg) for at least 6 months following trabeculectomy with mitomycin C. Each case had at least 6 months' follow-up after the phacoemulsification surgery.

SETTING

A tertiary care referral center.

INTERVENTION: Clear cornea phacoemulsification surgery, with minimal perioperative anti-inflammatory medication and retention of viscoelastic in eyes at case conclusion.

MAIN OUTCOME MEASURES: Intraocular pressure, visual acuity, and complications.

RESULTS

Nine eyes of 9 patients were identified. Mean preoperative IOP was 4. 2 +/- 1.4 mm Hg; the mean postoperative IOP was 7.3 +/- 2.8 mm Hg (P=.009). Intraocular pressure increased in all but 2 eyes. One of these 2 eyes experienced an acutely elevated IOP (34 mm Hg) on postoperative day 4, which dropped back to preoperative levels after trabeculectomy flap needling. Mean preoperative visual acuity was 20/300; mean postoperative visual acuity was 20/40.

CONCLUSION

Phacoemulsification surgery may be associated with a statistically significant elevation in IOP in previously filtered eyes with hypotony, resulting in resolution of hypotony in some of these challenging cases. Arch Ophthalmol. 2000;118:763-765