Intraocular Pressure Control following Phacoemulsification in Eyes with Pre-existing Aurolab Aqueous Drainage Implant (AADI)

Hiruni Kaushalya Wijesinghe, George Varghese Puthuran, Pradeep Yammanuru Ramulu, Arvin Kurian Ponnat, Madhan Mohan Reddy, Iswarya Mani, Subbaiah Ramasamy Krishnadas, Steven Jon Gedde

Research output: Contribution to journalArticlepeer-review


Purpose: To investigate intraocular pressure (IOP) control after phacoemulsification in adult glaucomatous eyes with a functioning non-valved Aurolab Aqueous Drainage Implant (AADI) compared to 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▒mmHg or increased by >20% from pre-phacoemulsification level requiring at least 1 additional glaucoma medication, IOP ≤5▒mmHg, reoperation for glaucoma, or loss of light perception vision). Results: The median interval between AADI and phacoemulsification was 11.5 months (range: 4-68▒mo), and the mean follow up time after phacoemulsification was 35.6±6.4 months. The cumulative probability of failure was 14% (95% CI=6-31%) in the phaco group and 6% (95% C I=3-13%) in the control group at 2-years (P=0.11). Mean IOP was reduced from 16.5±4.5▒mmHg preoperatively to 15.4±4.7▒mmHg 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.

Original languageEnglish (US)
JournalJournal of glaucoma
StateAccepted/In press - 2021


  • glaucoma drainage devices
  • intraocular pressure
  • phacoemulsification

ASJC Scopus subject areas

  • Ophthalmology


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