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Shannon Hunt, Bruce Ira Gaynes, Meenakshi Chaku; The Impact of Cataract Surgery in Patients with Low-Tension Glaucoma in a University Setting. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5315.
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The purpose of our study is to evaluate visual acuity (VA) and intraocular pressure (IOP) following cataract surgery in Low-Tension Glaucoma (LTG) and Primary Open-Angle Glaucoma (POAG) patients.
A retrospective study on patients who underwent uncomplicated cataract surgery from 2008 to present at Loyola University Medical Center was performed. LTG was defined as open-angle glaucoma with untreated IOP of 10-21 mm Hg. POAG was defined as open-angle glaucoma with untreated IOP ≥ 22 mm Hg. Exclusion criteria included patients with secondary glaucomas, prior intraocular surgery, or those who had combined cataract and glaucoma procedures. Primary outcome measures included VA, IOP, number of glaucoma medications, and need for additional laser or surgical intervention at 1 year after cataract surgery. Statistical analysis was performed using the paired Student’s t-test.
Thirty eyes (21 patients) with LTG and 69 eyes (50 patients) with POAG were evaluated. Mean VA (logMAR) in the LTG group improved from 0.33±0.14 at baseline to 0.20±0.24 at 1 year (p=0.008). Mean VA (logMAR) in POAG patients improved from 0.39±0.27 at baseline to 0.21±0.22 at 1 year (p=0.014). Mean IOP in the LTG group was 12.7±3.1 mm Hg at baseline and increased by 3.5% to 13.2±2.8 mm Hg at 1 year (p=0.322). Mean IOP in the POAG group was 15.6 ±3.2 mm Hg at baseline and decreased by 11.2% to 13.8±3.6 mm Hg at 1 year (p=0.004). Mean number of glaucoma medications in the LTG group remained unchanged (1.4 meds) after cataract surgery. In the POAG group, mean number of glaucoma medications decreased from baseline (2.0 meds) to 1 year (1.7 meds, p=0.197). One patient in the POAG group required laser trabeculoplasty during the 1 year period after cataract surgery. No filtration surgery was required in either group during the 1 year post-operative period.
Cataract surgery in both LTG and POAG patients significantly improved visual acuity at 1 year. A significant decrease in IOP was seen in the POAG group at 1 year but not in the LTG group. No significant differences were noted in the number of glaucoma medications at 1 year. Potential study limitations include relatively small sample size and retrospective study design.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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