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  • Title: Risk factors for uncontrolled intraocular pressure after phacoviscocanalostomy.
    Author: Park M, Hayashi K, Takahashi H, Shoji T, Chihara E.
    Journal: J Glaucoma; 2008 Sep; 17(6):431-5. PubMed ID: 18794675.
    Abstract:
    PURPOSE: To determine factors affecting the outcome of phacoviscocanalostomy in patients with cataract and primary open-angle glaucoma. METHODS: Factors for controlling intraocular pressure (IOP) were investigated in 180 patients using Cox multivariate proportional hazards survival regression. RESULTS: The mean preoperative IOP of 20.2+/-3.8 mm Hg decreased significantly (P<0.0001) to 15.3+/-2.6 mm Hg for 5 years postoperatively. The success probabilities defined as an IOP of 17 mm Hg or less or a 20% or greater reduction were 47.2% with or without medications and 31.4% without medications at 5 years. Preoperative IOP level [P=0.0013; odds ratio (OR), 1.14] and age (P=0.037; OR, 0.97) were risk factors in the success probability with or without medications. In the analysis without medications, the preoperative IOP (P<0.001; OR, 1.12), the preoperative number of antiglaucoma medications (P=0.033; OR, 1.27), age (P=0.003; OR, 0.96), and IOP spikes (P=0.028; OR, 1.22) were associated with failure. Sex, peeling of juxtacanalicular tissue, ruptured Descemet membrane, fibrin formation, and hyphema did not affect surgical outcomes. CONCLUSIONS: High preoperative IOP, the number of preoperative medications, postoperative IOP spikes (>30 mm Hg) increased the risk of failed IOP control after phacoviscocanalostomy. Increasing patient age decreased the risk of failure.
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