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Ferhina S Ali, Sasan Moghimi, Diego Tebaldi de Queiroz Barbosa, Guofu Huang, Shan C Lin; Anterior chamber biometrics and intraocular pressure dynamics following cataract extraction in glaucoma patients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):936.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the association of changes in anterior chamber biometrics and intraocular pressure after uncomplicated phacoemulsification in patients with primary open angle glaucoma.
In this prospective study, subjects with medically managed glaucoma underwent phacoemulsification with implantation of a foldable lens. Preoperatively and postoperatively, anterior chamber parameters were obtained by anterior segment coherence tomography. Measurements included the angle opening distance 500 μm anterior to the scleral spur (AOD500), the trabecular-iris space area 500 μm (TISA500) from the scleral spur, and iris curvature (I-Curv).
Data was analyzed from 34 glaucomatous eyes that underwent cataract surgery. The mean patient age was 77 years ± 7.39 (SD); 67% of the patients were women. On average, the patients were being treated with 1.77 (0.8) glaucoma medications. From preoperative to postoperative time points, the mean (SD) AOD 500 increased significantly by 0.180 mm (0.133) and the mean TISA 500 increased with marginal significance by 0.054 mm3 (.050). The mean IOP (SD) decreased significantly from 14.26 (4.029) to 11.73 (3.355) with a mean difference of -2.535 (4.214); p < 0.01. This change in intraocular pressure correlated by marginal significance with the increase in the AOD 500 (r=0.30, p=0.05) and with iris curvature (r=-0.032, p=0.05).
These findings provide additional etiologic basis for the postoperative reduction in intraocular pressure that is observed in glaucoma patients following cataract surgery. The reduction in IOP was proportional to the increase in the angle opening and iris curvature observed following cataract surgery. This study further establishes a role for consideration of cataract surgery in the treatment algorithm of primary open angle glaucoma.
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