Clinical and Anterior Segment OCT Predictors of Intraocular Pressure After Phacoemulsification in Eyes with Prior Trabeculectomy
Sara Okamoto, Akiko Narita, Miyuki Fujiwara, Riku Akatsuka, Tasuku Sunami, Tomoe Miyake, Momoka Miyake, Jiro Seguchi, Yuki MorizanePrécis
Lower preoperative IOP, greater bleb height, and a shorter trabeculectomy-to-phacoemulsification interval are associated with greater postoperative IOP elevation in eyes with prior trabeculectomy.
Purpose:
To identify clinical factors and filtering bleb morphological features associated with intraocular pressure (IOP) changes after phacoemulsification in eyes with prior trabeculectomy.
Patients and Methods:
This retrospective, consecutive case series included 76 eyes of 71 Japanese patients who underwent phacoemulsification following primary trabeculectomy. Bleb morphology was evaluated preoperatively using three-dimensional anterior segment optical coherence tomography (AS-OCT). The primary outcome was the change in IOP from baseline to one year after phacoemulsification. Associations between IOP change and pre-phacoemulsification AS-OCT parameters and clinical variables were assessed. For categorical analyses, eyes exhibiting both an IOP increase of >2 mmHg and a percentage IOP increase of >20% at one year were classified into the IOP increase group; the remaining eyes constituted the no IOP increase group.
Results:
Fifty-one eyes were assigned to the no IOP increase group and 25 eyes to the IOP increase group. Pre-phacoemulsification IOP differed significantly between the groups (
Conclusions:
IOP elevation after phacoemulsification in post-trabeculectomy eyes was associated with lower IOP and greater bleb height before phacoemulsification, as well as with a shorter trabeculectomy–phacoemulsification interval.