Intraocular pressure 3 to 4 hours and 20 hours after cataract surgery with and without ab interno trabeculectomy

Purpose To evaluate intraocular pressure (IOP) immediately after cataract surgery with or without ab interno trabeculectomy (Trabectome) and whether trabeculectomy-related hyphema increases the risk for IOP spikes. Settings Private glaucoma practice. Design Retrospective interventional nonrandomized comparative chart review. Methods Intraocular pressure was measured 3 to 4 hours and 20 hours postoperatively. Results The combined group comprised 73 eyes of 73 patients and the cataract-only group, 75 eyes of 75 patients. The mean preoperative IOP was 15.8 mm Hg ± 3.6 (SD) and 14.9 ± 3.0 mm Hg, respectively (P =.09). In the combined group, the IOP decrease was significant at 3 to 4 hours (P =.0003) and 20 hours (P =.0007). In the cataract-only group, the IOP increased significantly (P <.0001 and P =.0035, respectively). The mean IOP was significantly lower in the combined group than in the cataract-only group at 3 to 4 hours (12.8 ± 5.9 mm Hg versus 19.7 ± 7.5 mm Hg) and 20 hours (12.7 ± 7.0 mm Hg versus 17.2 ± 5.9 mm Hg) (both P <.0001). Significantly fewer eyes in the combined group than in the cataract-only group had IOP spikes (overall, P =.0077; 3 to 4 hours, P =.001). Hyphema occurred in 35 eyes (47.9%) in the combined group; however, the IOP was similar with or without hyphema. Only 1 eye with an IOP spike in the combined group had hyphema. Conclusion Combining ab interno trabeculectomy and cataract surgery reduced short-term postoperative IOP and the incidence of IOP spikes despite the common hyphema. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.