Intraocular Pressure Control after Trabeculectomy, Phacotrabeculectomy and Phacoemulsification in a Hispanic Population.

Autor: L Jung J; Instructor, Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA., Isida-Llerandi CG; Glaucoma Fellowship, Asociacion para evitar la ceguera en Mexico IAP, Vicente Garcia Torres 46, San Lucas Coyoacan, DF, Maxico., Lazcano-Gomez G; Glaucoma Associate Professor, Asociacion para evitarla ceguera en Mexico IAP, Vicente Garcia Torres 46, San Lucas Coyoacan, DF, Maxico., SooHoo JR; Assistant Professor, Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA., Kahook MY; Professor, Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Jazyk: angličtina
Zdroj: Journal of current glaucoma practice [J Curr Glaucoma Pract] 2014 May-Aug; Vol. 8 (2), pp. 67-74. Date of Electronic Publication: 2014 Jun 12.
DOI: 10.5005/jp-journals-10008-1164
Abstrakt: Purpose: To compare the efficacy of different surgical strategies for intraocular pressure (IOP) control in Hispanic glaucoma patients with and without visually significant cataracts.
Design: Comparative retrospective consecutive case series.
Methods: The charts of 153 consecutive patients with primary open angle glaucoma who underwent either trabeculectomy alone (n = 51), phacotrabeculectomy (n = 51), or phacoemulsification alone (n = 51) were reviewed to compare IOP control, the number of glaucoma medications required postoperatively, and the inci dence of surgical complications.
Results: Preoperative IOP was 17.5 ± 5.2 mm Hg in the trabe-culectomy group, 15.4 ± 4.5 mm Hg in the phacotrabeculectomy group and 13.9 ± 2.9 mm Hg in the phacoemulsification group (p < 0.001 for all comparisons). Mean IOP reduction from baseline was 4.2 ± 6.9 (24.6%) for the trabeculectomy group, 2.9 ± 5.0 (20.8%) for the phacotrabeculectomy group, and 0.9 ± 3.4 (6.5%) for the phacoemulsification group (p = 0.009). The number of IOP-lowering medications required postoperatively decreased significantly in all three groups (p = 0.001). The rate of early and late postoperative complications was similar between the trabeculectomy and phacotrabeculectomy groups and less for the phacoemulsification group.
Conclusion: Trabeculectomy and phacotrabeculectomy are both viable surgical options for managing open angle glau coma. Both resulted in similar rates of success, IOP reduction, decrease in use of IOP-lowering medications and post operative complication rates. Phacoemulsification alone had a lower success rate and greater need for postoperative IOP-lowering medications compared to trabeculectomy alone or phacotrabeculectomy. Phacoemulsification alone may be a reasonable option for patients with visually significant cataract and lower baseline IOP. How to cite this article: Jung JL, Isida-Llerandi CG, Lazcano-Gomez G, SooHoo JR, Kahook MY. Intraocular Pressure Control after Trabeculectomy, Phacotrabeculectomy and Phaco-emulsification in a Hispanic Population. J Curr Glaucoma Pract 2014;8(2):67-74.
Databáze: MEDLINE