Phaco after trab may increase bleb failure rates at 1 year, but not 2 years

Phacoemulsification done after trabeculectomy may significantly increase the rates of bleb failure in the following 12 months, but not at 24 months, according to a recent study published in Clinical & Experimental Ophthalmology.

For this retrospective case control study, Dan Q Nguyen, FRCOphth, and fellow researchers at the University of Melbourne and the Royal Victorian Eye & Ear Hospital, Melbourne, Australia, included 48 patients who had undergone trabeculectomy and ≥2 years of follow-up. Patients were classified into two groups: those who had phacoemusification subsequent to trabeculectomy (trab_phaco; n = 18), and those who were pseudophakic for >6 months preceding trabeculectomy (Phaco_trab; n = 30). These groups were matched for length of follow-up of 2 years from time of trabeculectomy.

Researchers found no significant differences between the groups in achieving the primary outcome measures of target IOP of criteria A ≤12 mmHg, criteria B ≤15 mmHg, or criteria C ≤18 mmHg with or without additional topical treatment at 12 months (P = 1.0) and at 24 months (P = 0.330). In the first 12 months, significantly more trabeculectomies failed in the Trab_phaco group and required additional intervention for IOP control compared with the Phaco_trab group (39% vs 10%; P = 0.028). This trend continued at 24 months, but no significant differences in failure rates were seen between the groups (P = 0.522).

To access this study, go to the journal's website.