Surgical outcome after early intraocular pressure elevation following combined cataract extraction and trabeculectomy.

BACKGROUND AND OBJECTIVES

We report on the incidence and course of early postoperative intraocular pressure (IOP) elevation and related surgical outcome following combined manual extracapsular cataract extraction (ECCE), using a sclerocorneal tunnel incision and trabeculectomy.

PATIENTS AND METHODS

The combined procedure was the initial surgery in each eye. Intraocular pressure was measured during the first 4 days, at 1 week, and thereafter following surgery.

RESULTS

Of 38 eyes (38 consecutive adults), postoperative IOP elevation to > 25 mm Hg was found in 7 eyes (18.4%) during the first 3 postoperative days. The IOP was reduced to < or = 20 mm Hg without hypotensive medication in 3 of them within the first 3-7 postoperative days, and remained so after 7-16 months (mean, 10.3 +/- 4.9 months). Each of the other 4 eyes underwent argon-laser suture lysis 8-10 days after surgery due to unstable IOP which rose to > 30 mm Hg. Two weeks after the operation and thereafter, ie, after 8-22 months (mean, 12.8 +/- 6.4 months), each of these 4 eyes necessitated 1-4 (mean, 2.5 +/- 1.3) hypotensive medications.

CONCLUSION

This study raises the possibility that in eyes with early IOP elevation, a delay in promoting aqueous outflow beyond a critical period during the first postoperative week might become a risk factor for full surgical success.