2MD, Ankara Training and Research Hospital, Ophthalmology Clinic, Ankara, Türkiye
3Assoc. Prof. Lokman Hekim University, Ophthalmology Clinic, Ankara, Türkiye
4Assoc. Prof. Başkent University, Ophthalmology Clinic, Ankara, Türkiye DOI : 10.37844/glau.cat.2023.18.24 Purpose: To evaluate the effect of phacoemulsification (PE) on intraocular pressure (IOP) control and bleb type in pseudoexfoliative glaucoma (PXG) patients with filtering blebs.
Materials and Methods: Thirty-one PXG patients with filtering blebs who underwent uncomplicated PE were evaluated. Those with less than 2 years between trabeculectomy and phacoemulsification surgeries were classified as group 1, those with more than 2 years were classified as group 2. The study evaluated the patients? IOP and glaucoma medication use before and after surgeries, including measurements taken at various intervals up to three years post-surgery. Bleb types and surgical success were evaluated at before and 1 year after PE. Surgical success was defined as IOP levels between 5 and 18 mmHg without the use of any antiglaucoma medication (complete success) or with the use of antiglaucoma medications (qualified success). Patients who underwent glaucoma surgery after PE were considered unsuccessful.
Results: Statistically significant differences were found between the first month after PE and the last visit in terms of IOP and medications (p=0.010; p<0.001). Complete and qualified success was higher in Group 2 at the last visit. The most common bleb type before PE was diffuse (58.1%), while after PE it was flat (51.6%).
Conclusions: Early cataract surgery may be a better option for PXG patients with filtering blebs before the need for trabeculectomy arises, as cataract surgery can negatively impact the functioning of the bleb. Careful management of cataract progression is crucial in optimizing long-term visual and glaucoma management outcomes in these patients.
Keywords : Pseudoexfoliative glaucoma, Phacoemulsification, Trabeculectomy