Effect of Phacoemulsification on Intraocular Pressure in Eyes with Functioning Tube Shunts

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Shalaby Wesam Shamseldin; Patel Sonali; Lam Sophia S.; Ganjei Allen; Shukla Aakriti Garg; Kolomeyer Natasha; Lee Daniel; Katz L. Jay; Moster Marlene R.; Myers Jonathan; Razeghinejad Reza

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Journal Paper

Paper Information

Journal: Journal of Ophthalmic and Vision Research Year:2023 | Volume:18 | Issue:2 Page(s): 150-156

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Title

Effect of Phacoemulsification on Intraocular Pressure in Eyes with Functioning Tube Shunts

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Keywords

Cataract Extraction

Glaucoma Drainage Implants

Intraocular Pressure

Phacoemulsification

Abstract

Purpose: To evaluate the effect of Phacoemulsification on Intraocular Pressure (IOP) in eyes with functioning tube shunts. Methods: This was a retrospective chart review of primary open-angle glaucoma (POAG) patients with a functioning tube who underwent Phacoemulsification and had ≥24 months of follow-up. The primary end point was defined as surgical failure (IOP > 21 mmHg) at month 24, progression to no light perception (NLP) vision, glaucoma reoperation, or implant removal. Surgical failure defined as IOP >18 and >15 mmHg, changes in visual acuity (VA), IOP, and number of medications were assessed. Results: Twenty-seven eyes of 27 patients with moderate or severe POAG were included. The mean age of the patients was 64. 2 ± 10. 8 years. The interval between the tube shunt and Phacoemulsification was 28. 8 ± 25. 0 months. At the end of the study, four (14. 8%) eyes met the failure criteria,the average time to failure was 9. 3 ± 3. 8 months. The causes of failure were high IOP in two (50. 0%) and glaucoma reoperation in two (50. 0%) eyes,however, no eyes progressed to NLP vision. Surgical failure defined as IOP >18 and >15 mmHg showed an increasing failure rate (18. 5% and 48. 5%, respectively). The mean IOP and medications number remained stable at month 24 compared to baseline (P = 0. 131 and P = 0. 302, respectively). Initially, VA showed improvement, with the greatest improvement at 6 months (P = 0. 001), but at 24 months the improvement was no longer significant (P = 0. 430). Conclusion: Phacoemulsification in patients with functioning tubes did not change the mean IOP in most of the patients (86. 2%),the number of medications also did not increase.

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