Pseudophakic cystoid macular oedema and posterior capsular opacification rates after combined phaco‐trabeculectomy vs. phaco alone

Purpose To assess the risk for pseudophakic cystoid macular oedema (PCME) and posterior capsular opacification (PCO) associated with combined cataract surgery and trabeculectomy compared to cataract surgery alone. Methods Data analysis of subjects who underwent routine cataract surgery without and w...

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Veröffentlicht in:Acta ophthalmologica (Oxford, England) England), 2025-02, Vol.103 (1), p.115-120
Hauptverfasser: Levinger, Eliya, Ostrovsky, Michael, Friehmann, Asaf, Elhaddad, Omar, Tole, Derek, Darcy, Kieren, Leadbetter, Duncan, Tuuminen, Raimo, Goldberg, Mordechai, Achiron, Asaf
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container_title Acta ophthalmologica (Oxford, England)
container_volume 103
creator Levinger, Eliya
Ostrovsky, Michael
Friehmann, Asaf
Elhaddad, Omar
Tole, Derek
Darcy, Kieren
Leadbetter, Duncan
Tuuminen, Raimo
Goldberg, Mordechai
Achiron, Asaf
description Purpose To assess the risk for pseudophakic cystoid macular oedema (PCME) and posterior capsular opacification (PCO) associated with combined cataract surgery and trabeculectomy compared to cataract surgery alone. Methods Data analysis of subjects who underwent routine cataract surgery without and with concomitant trabeculectomy at the Department of Ophthalmology, Bristol Eye Hospital, the UK, between January 2008 and December 2017. Odds ratios (ORs) for PCME between the types of surgeries were calculated using univariate and multivariate regression analysis. Multivariate Cox regression controlling for age and gender was used to estimate the hazard ratio (HR) for neodymium‐doped yttrium aluminium garnet (Nd:YAG) laser capsulotomies. Results This study included 56 973 cataract surgeries without and 288 with concomitant trabeculectomy (phaco‐trab) with a mean follow‐up time of 6.9 ± 4.2 years. Baseline variables (age and gender, diabetes, pseudoexfoliation, use of pupil expansion device and postoperative follow‐up time) were comparable between the groups. Postoperative rates of PCME remained non‐significant between the cataract surgery and phaco‐trabe groups both in uni‐ and multi‐variate analysis (OR 0.347, 95%CI 0.049–2.477, p = 0.291). Furthermore, in Cox regression analysis adjusted for the patients' age and gender, Nd:YAG laser capsulotomy rates remained non‐significant between the cataract surgery and phaco‐trabe groups (HR 1.250, 95%CI 0.883–1.769, p = 0.209). Conclusions In our large cohort study, combining trabeculectomy with cataract surgery did not predispose to an increased PCME or Nd:YAG laser capsulotomy rates.
doi_str_mv 10.1111/aos.16766
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Methods Data analysis of subjects who underwent routine cataract surgery without and with concomitant trabeculectomy at the Department of Ophthalmology, Bristol Eye Hospital, the UK, between January 2008 and December 2017. Odds ratios (ORs) for PCME between the types of surgeries were calculated using univariate and multivariate regression analysis. Multivariate Cox regression controlling for age and gender was used to estimate the hazard ratio (HR) for neodymium‐doped yttrium aluminium garnet (Nd:YAG) laser capsulotomies. Results This study included 56 973 cataract surgeries without and 288 with concomitant trabeculectomy (phaco‐trab) with a mean follow‐up time of 6.9 ± 4.2 years. Baseline variables (age and gender, diabetes, pseudoexfoliation, use of pupil expansion device and postoperative follow‐up time) were comparable between the groups. Postoperative rates of PCME remained non‐significant between the cataract surgery and phaco‐trabe groups both in uni‐ and multi‐variate analysis (OR 0.347, 95%CI 0.049–2.477, p = 0.291). Furthermore, in Cox regression analysis adjusted for the patients' age and gender, Nd:YAG laser capsulotomy rates remained non‐significant between the cataract surgery and phaco‐trabe groups (HR 1.250, 95%CI 0.883–1.769, p = 0.209). Conclusions In our large cohort study, combining trabeculectomy with cataract surgery did not predispose to an increased PCME or Nd:YAG laser capsulotomy rates.</description><identifier>ISSN: 1755-375X</identifier><identifier>ISSN: 1755-3768</identifier><identifier>EISSN: 1755-3768</identifier><identifier>DOI: 10.1111/aos.16766</identifier><identifier>PMID: 39394695</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Aged ; Aluminum ; Capsule Opacification - diagnosis ; Capsule Opacification - epidemiology ; Capsule Opacification - etiology ; Capsule Opacification - surgery ; cataract surgery ; Cataracts ; Diabetes mellitus ; Edema ; Eye surgery ; Female ; Follow-Up Studies ; Gender ; Humans ; Incidence ; Lasers ; Macular Edema - diagnosis ; Macular Edema - etiology ; Macular Edema - surgery ; Male ; Middle Aged ; Original ; Phacoemulsification - adverse effects ; Phacoemulsification - methods ; posterior capsular opacification ; Postoperative Complications - epidemiology ; Pseudophakia - complications ; pseudophakic cystoid macular oedema ; Regression analysis ; Retrospective Studies ; Risk Factors ; Surgery ; trabeculectomy ; Trabeculectomy - methods ; Visual Acuity ; Yttrium</subject><ispartof>Acta ophthalmologica (Oxford, England), 2025-02, Vol.103 (1), p.115-120</ispartof><rights>2024 The Author(s). published by John Wiley &amp; Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.</rights><rights>2024 The Author(s). 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Methods Data analysis of subjects who underwent routine cataract surgery without and with concomitant trabeculectomy at the Department of Ophthalmology, Bristol Eye Hospital, the UK, between January 2008 and December 2017. Odds ratios (ORs) for PCME between the types of surgeries were calculated using univariate and multivariate regression analysis. Multivariate Cox regression controlling for age and gender was used to estimate the hazard ratio (HR) for neodymium‐doped yttrium aluminium garnet (Nd:YAG) laser capsulotomies. Results This study included 56 973 cataract surgeries without and 288 with concomitant trabeculectomy (phaco‐trab) with a mean follow‐up time of 6.9 ± 4.2 years. Baseline variables (age and gender, diabetes, pseudoexfoliation, use of pupil expansion device and postoperative follow‐up time) were comparable between the groups. Postoperative rates of PCME remained non‐significant between the cataract surgery and phaco‐trabe groups both in uni‐ and multi‐variate analysis (OR 0.347, 95%CI 0.049–2.477, p = 0.291). Furthermore, in Cox regression analysis adjusted for the patients' age and gender, Nd:YAG laser capsulotomy rates remained non‐significant between the cataract surgery and phaco‐trabe groups (HR 1.250, 95%CI 0.883–1.769, p = 0.209). 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Methods Data analysis of subjects who underwent routine cataract surgery without and with concomitant trabeculectomy at the Department of Ophthalmology, Bristol Eye Hospital, the UK, between January 2008 and December 2017. Odds ratios (ORs) for PCME between the types of surgeries were calculated using univariate and multivariate regression analysis. Multivariate Cox regression controlling for age and gender was used to estimate the hazard ratio (HR) for neodymium‐doped yttrium aluminium garnet (Nd:YAG) laser capsulotomies. Results This study included 56 973 cataract surgeries without and 288 with concomitant trabeculectomy (phaco‐trab) with a mean follow‐up time of 6.9 ± 4.2 years. Baseline variables (age and gender, diabetes, pseudoexfoliation, use of pupil expansion device and postoperative follow‐up time) were comparable between the groups. Postoperative rates of PCME remained non‐significant between the cataract surgery and phaco‐trabe groups both in uni‐ and multi‐variate analysis (OR 0.347, 95%CI 0.049–2.477, p = 0.291). Furthermore, in Cox regression analysis adjusted for the patients' age and gender, Nd:YAG laser capsulotomy rates remained non‐significant between the cataract surgery and phaco‐trabe groups (HR 1.250, 95%CI 0.883–1.769, p = 0.209). Conclusions In our large cohort study, combining trabeculectomy with cataract surgery did not predispose to an increased PCME or Nd:YAG laser capsulotomy rates.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>39394695</pmid><doi>10.1111/aos.16766</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-6325-7175</orcidid><orcidid>https://orcid.org/0000-0003-1550-8125</orcidid><orcidid>https://orcid.org/0000-0001-7128-3288</orcidid><orcidid>https://orcid.org/0000-0001-6315-6908</orcidid><oa>free_for_read</oa></addata></record>
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subjects Aged
Aluminum
Capsule Opacification - diagnosis
Capsule Opacification - epidemiology
Capsule Opacification - etiology
Capsule Opacification - surgery
cataract surgery
Cataracts
Diabetes mellitus
Edema
Eye surgery
Female
Follow-Up Studies
Gender
Humans
Incidence
Lasers
Macular Edema - diagnosis
Macular Edema - etiology
Macular Edema - surgery
Male
Middle Aged
Original
Phacoemulsification - adverse effects
Phacoemulsification - methods
posterior capsular opacification
Postoperative Complications - epidemiology
Pseudophakia - complications
pseudophakic cystoid macular oedema
Regression analysis
Retrospective Studies
Risk Factors
Surgery
trabeculectomy
Trabeculectomy - methods
Visual Acuity
Yttrium
title Pseudophakic cystoid macular oedema and posterior capsular opacification rates after combined phaco‐trabeculectomy vs. phaco alone
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