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Home  >  Medical Research Archives  >  Issue 149  > An Alternative Method of Phacoemulsification Surgery in Eyes with Functional Trabeculectomies
Published in the Medical Research Archives
Jan 2024 Issue

An Alternative Method of Phacoemulsification Surgery in Eyes with Functional Trabeculectomies

Published on Jan 30, 2024




Aims: To report success proportions in functional trabeculectomised eyes undergoing phaco-emulsifcation with a novel curvilinear capsulorhexis method.

Methods: An observational series. Seventy two eyes of 72 patients were identified who underwent cataract surgery in eyes with functional prior trabeculectomy surgery using a Leweke cannula (cases). A previously reported group of 53 eyes in 53 patient who had routine cataract surgery (not using this technique) post-trabeculectomy surgery was used to compare outcomes (controls).

Main outcome measure: The primary outcome measure was intraocular pressure (IOP) success (IOP ≤21, ≤18, ≤15 mmHg) at 5 years post cataract surgery. Complete success was no new medication or surgical intervention for IOP and partial success was additional medical therapy required to achieve the IOP target.

Results: At final follow-up, the overall failure proportion of the combined groups for an IOP ≤21mmHg was 20% (24/125) at final review. Thirty percent who were a partial success prior to cataract surgery, failed in both controls and cases at final follow-up. Of those who were a complete success prior to phaco-emulsification; 33% were partial successes and 30% failed in the control group; 50% were partial successes and 10% failed in the case group, at final follow-up.

Logistic regression for an outcome of failure showed the Leweke cannula to be protective OR 0.28 (95% CI 0.09 to 0.85, p=0.03). African/Caribbean ethnicity was a risk factor for failure.

Conclusions: Our results suggest that cataract surgery may affect trabeculectomy outcomes, but not as profoundly as is currently perceived. Using the Leweke technique seems to result in earlier medication recommencement, but a strong reduction in the need for further surgical intervention in fully functional trabeculectomies.

Author info

Mr Ian Murdoch, Ms Rashmi Mathew

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