Efficacy of glaucoma filtration surgery in pseudophakic patients with or without conjunctival scarring

PURPOSE: To analyze the intraocular pressure (IOP), glaucoma medication requirements, and visual acuity after glaucoma filtration surgery in pseudophakic eyes. SETTING: Private practice, Boston, Massachusetts, USA. METHODS: The results of glaucoma filtration surgery in 47 eyes of 40 pseudophakic patients with a minimum follow-up of 1 year were retrospectively reviewed. Eyes with previously surgically manipulated conjunctiva in the area of filtration were compared to eyes without previous manipulation. RESULTS: Preoperatively, the mean IOP was 25 mm Hg +/- 7.3 (SD); mean number of glaucoma medications, 3.3 +/- 1.0; and mean logMAR visual acuity, 0.41 +/- 0.38. At the final follow-up visit (mean 36.5 +/- 31.5 months), the respective means were 13.6 +/- 6.6 mm Hg (P<.001), 0.9 +/- 1.4 (P<.001), and 0.46 +/- 0.43 (P=.53). The mean postoperative IOP, glaucoma medication requirements, and visual acuity at the final follow-up in eyes with virgin conjunctiva and eyes with previously manipulated conjunctiva were, respectively, as follows: IOP, 12.5 +/- 3.2 mm Hg and 14.1 +/- 7.6 mm Hg (P=.52); medications, 1.1 +/- 1.3 and 0.9 +/- 1.4 (P=.66); and logMAR acuity, 0.6 +/- 0.52 and 0.4 +/- 0.39 (P=.23). CONCLUSIONS: Glaucoma filtration surgery in pseudophakic eyes significantly improved IOP and reduced glaucoma medication requirements while maintaining stability of vision. There were no statistically significant differences in final IOP, glaucoma medication requirements, or visual acuity between eyes with virgin conjunctiva and eyes with previously surgically manipulated conjunctiva.