[Intraocular pressure evolution after phacoemulsification in eyes with filtering blebs].

PURPOSE: To evaluate the effect of phacoemulsification in functioning filtered glaucoma eyes, on intraocular pressure (IOP) and the use of antiglaucomatous medication. To determine the influence of time lapsed between surgeries on the results. METHOD: 20 eyes of 20 patients treated by phacoemulsification in 1997, who had undergone previous glaucoma filtering surgery in which IOP was well controlled, were retrospectively evaluated. RESULTS: Mean preoperative IOP was 13.2+/-4.1 mmHg (range: 5-21). Mean IOP increased after phacoemulsification in every postoperative control (0.9-2.6 mm Hg), the differences were not significant. Mean score medication increased (0.2-1) after surgery, but the difference was not significant. Mean preoperative IOP was 5.7 mm Hg lower in patients whose phacoemulsification was performed before 18 months after trabeculectomy than those whose surgery was performed later (P<0.001). Moreover, the patients operated earlier showed an IOP increase after phacoemusification (3.2-3.9 mm Hg) during the first six postoperative months (P<0.05). However, the patients who underwent filtering surgery later, did not show any significant change in postoperative IOP. Visual acuity (VA) significantly improved after cataract surgery (P<0.05). VA was equal or better than 0.5 in 43.75% of the patients, six months postoperatively. CONCLUSIONS: We have found a slight increase in IOP after phacoemulsification in filtered glaucoma eyes. To reduce the time lapsed between trabeculectomy and phacoemulsification could be a risk factor predisposing to failure of previously functioning filtering blebs.