Purpose: 

The aim was to investigate intraocular pressure (IOP) control after phacoemulsification in adult glaucomatous eyes with a functioning nonvalved Aurolab Aqueous Drainage Implant (AADI) compared with eyes that did not have cataract extraction post-AADI.

Methods: 

In this retrospective study, we reviewed records of 47 patients (47 eyes) who had a clear corneal phacoemulsification after AADI placement with a minimum of 2 years of follow up. The control group included 89 patients (89 eyes) who had a functional AADI at 1 year, minimum of 3 years of follow up post-AADI implantation, and no cataract extraction. The main outcome measure was failure (IOP >21 mm Hg or increased by >20% from prephacoemulsification level requiring at least 1 additional glaucoma medication, IOP ≤5 mm Hg, reoperation for glaucoma, or loss of light perception vision).

Results: 

The median interval between AADI and phacoemulsification was 11.5 months (range: 4 to 68 mo), and the mean follow-up time after phacoemulsification was 35.6±6.4 months. The cumulative probability of failure was 14% (95% confidence interval=6%-31%) in the phaco group and 6% (95% confidence interval=3%-13%) in the control group at 2 years (P=0.11). Mean IOP was reduced from 16.5±4.5 mm Hg preoperatively to 15.4±4.7 mm Hg at 2 years after phacoemulsification (P=0.10). Mean LogMAR visual acuity improved from 1.1±0.6 preoperatively to 0.6±0.7 at 2 years after phacoemulsification (P<0.001).

Conclusions: 

In eyes with a pre-existing AADI, phacoemulsification resulted in visual improvement without a significant rise in IOP or increased risk of AADI failure after 2 years follow up.

中文翻译：

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使用预先存在的 Aurolab 水引流植入物进行白内障超声乳化术后眼压控制

目的： 

目的是研究使用功能性无瓣膜 Aurolab 水性引流植入物 (AADI) 的成人青光眼乳化术后眼压(IOP) 控制情况，与 AADI 后未进行白内障摘除术的眼睛进行比较。

方法： 

在这项回顾性研究中，我们回顾了 47 名患者（47 只眼）的记录，这些患者在 AADI 植入后进行了清晰的角膜超声乳化手术，并进行了至少 2 年的随访。对照组包括 89 名患者（89 只眼），他们在 1 年时具有功能性 AADI，植入 AADI 后至少随访 3 年，且未进行白内障摘除术。主要结果指标为失败（眼压>21毫米汞柱或比超声乳化术前乳化水平增加>20%，需要至少1种额外的青光眼药物，眼压≤5毫米汞柱，青光眼再次手术，或光感视力丧失）。

结果： 

AADI 与超声乳化术之间的中位间隔为 11.5 个月（范围：4 至 68 个月），超声乳化术后平均随访时间为 35.6±6.4 个月。2 年时超声乳化组的累积失败概率为 14%（95% 置信区间=6%-31%），对照组为 6%（95% 置信区间=3%-13%）（ P = 0.11） ）。平均眼压从术前的 16.5±4.5 mm Hg 降至超声乳化术后 2 年的 15.4±4.7 mm Hg（P =0.10）。平均LogMAR视力从术前的1.1±0.6提高到超声乳化术后2年的0.6±0.7（P <0.001）。

结论： 

对于已有 AADI 的眼睛，超声乳化手术可改善视力，但 2 年后随访后，眼压不会显着升高，也不会增加 AADI 失败的风险。