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The fate of trabeculectomies following subsequent cataract surgeryH. Mietz, A. Andresen, G. K. Krieglstein
Background: The combined procedure of glaucoma and cataract surgery seems clinically important in many cases. Most authors favor to use anti-metabolites for such procedures. For this reason, we evaluated cases in which the two surgical procedures were performed separately.
Methods: We retrieved 107 cases in which a cataract surgery with IOL implantation was performed following a previous trabeculectomy.
Results: The mean interval between glaucoma surgery and cataract surgery was 58.1 months. The mean follow-up after cataract surgery was 30.2 months with a minimum of 6 months. The mean central visual acuity increased by 4 lines. Before cataract surgery, 53% of the eyes had a com-plete success (group 1), while 28% had a qualified success (group 2) and the remaining 19% were failures (group 3). From group 1, 61% remained being a complete success until the last visit. No eye developed a failure. In group 2, 23% were a complete success at the final follow-up, while 4% fai-led. In group 3, only 35% were failures while the remaining 65% were a complete or qualified success.
Conclusions: Eyes with a complete surgical success following trabeculec-tomy seem to have a favorable prognosis after subsequent cataract surgery. Eyes with a qualified success or failures have a slight chance of improvement of IOP regulation. Separate surgical interventions do not necessarily have an unfavorable outcome.
Department of Ophthalmology, Unversity of Cologne, D-50924 Köln