Risk factors for uncontrolled intraocular pressure after phacoviscocanalostomy.

PURPOSE: To determine factors affecting the outcome of phacoviscocanalostomy in patients with cataract and primary open-angle glaucoma.

METHODS

Factors for controlling intraocular pressure (IOP) were investigated in 180 patients using Cox multivariate proportional hazards survival regression.

RESULTS

The mean preoperative IOP of 20.2+/-3.8 mm Hg decreased significantly (P<0.0001) to 15.3+/-2.6 mm Hg for 5 years postoperatively. The success probabilities defined as an IOP of 17 mm Hg or less or a 20% or greater reduction were 47.2% with or without medications and 31.4% without medications at 5 years. Preoperative IOP level [P=0.0013; odds ratio (OR), 1.14] and age (P=0.037; OR, 0.97) were risk factors in the success probability with or without medications. In the analysis without medications, the preoperative IOP (P<0.001; OR, 1.12), the preoperative number of antiglaucoma medications (P=0.033; OR, 1.27), age (P=0.003; OR, 0.96), and IOP spikes (P=0.028; OR, 1.22) were associated with failure. Sex, peeling of juxtacanalicular tissue, ruptured Descemet membrane, fibrin formation, and hyphema did not affect surgical outcomes.

CONCLUSIONS

High preoperative IOP, the number of preoperative medications, postoperative IOP spikes (>30 mm Hg) increased the risk of failed IOP control after phacoviscocanalostomy. Increasing patient age decreased the risk of failure.