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Trabeculectomy Case Study

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Trabeculectomy Bleb Function after uneventful phacoemulsification

Abstract
Background: The aim of this study was to compare superior and temporal clear corneal incisions of uneventful phacoemulsification and in-the-bag intraocular lens implantation on intraocular pressure control and the bleb morphology in eyes that have undergone previous successful trabeculectomy.
Methods: In this Prospective case-control study, a total of 100 eyes of 100 patients previously undergone trabeculectomy without antimetabolites, divided into two groups. Group A (temporal group) including 50 patients underwent phacoemulsification with a temporal corneal incision and group B (superior group) including 50 patients underwent phacoemulsification with a superior corneal …show more content…

A total of 100 eyes of 100 patients previously undergone trabeculectomy without antimetabolites divided into two groups. Group A (temporal group) including 50 patients underwent phacoemulsification with a temporal corneal incision and group B (superior group) including 50 patients underwent phacoemulsification with a superior corneal incision. All 100 patients underwent cataract surgery at least six months after the previous successful trabeculectomy surgery. All patients were assigned consecutively in both groups.
Ophthalmological examinations consisted of the best corrected visual acuity, slit lamp examination to detect the type of cataract and to make grading of the filtering bleb using the Wuerzburg bleb classification score[16], filtering bleb photography and Goldman applanation tonometry. At least three consecutive measurements were taken and the average of these measurements was taken as the preoperative IOP.
The following bleb morphological criteria were evaluated (Table …show more content…

Both groups were clinically matched regarding age (p=0.58) and gender (p=0.75). Both groups were clinically and statistically matched regarding the preoperative IOP (P = 0.40) and the bleb morphology score (p=0.64). Patients in both groups were followed up for one year postoperatively.
The mean IOP at each follow-up visit in both groups is shown in Table 3. Regarding the temporal group, in the first postoperative week, the IOP was higher by 1 or 2 mmHg in in 22 eyes (45%), lower in 3 eyes (5%) and unchanged in 25 eyes (50%). In the superior group, the IOP was higher by 1 mmHg in 25 eyes (50%) and unchanged in 25 eyes (50%).
At the last visit, the mean IOP in the temporal group was 17.55±1.47 and for the superior group was 16.90±1.71. The difference between the two groups was insignificant (p=0.21). The difference between preoperative and postoperative IOP within the same group was found to be statistically insignificant throughout the follow up period (p= 0.51 in temporal group, p= 0.85 in the superior group). Table 3: comparison between the temporal and superior groups regarding the mean intraocular pressure preoperatively and at each follow-up visit.
Characteristics Temporal

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