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A. B. McNab, B. A. Hughes, A. Goyal, M. S. Juzych, M. Y. Alexander, S. D. Wolfe, C. Kim; The Effect of Cataract Surgery on Intraocular Pressures in Patients With and Without Glaucoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2456.
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To compare the effect of cataract surgery on intraocular pressure (IOP) in patients with and without glaucoma.
This retrospective study included 179 glaucomatous eyes and 210 non-glaucomatous eyes, all of which had uncomplicated cataract surgery with posterior chamber lens implant between September 2006 and March 2008. No more than one eye was used per patient. Patients with ocular surgery or laser trabeculoplasty within one year prior to or one year after cataract surgery were excluded from the study. Postoperative IOP control in patients with glaucoma was compared to patients without glaucoma. IOP and number of glaucoma medications were recorded at 1 week, 1, 3, 6, and 12 months postoperatively. Paired and unpaired t-tests as well as chi square were used to analyze the data.
Both groups were comparable in race and gender. The glaucoma group was significantly older at 72.3 years +/- 10.4 compared with the non-glaucoma group at 69.0 +/- 10.8 years (P=.002). Mean IOP prior to surgery were comparable between the two groups, 16.3 mm Hg +/- 4.5 vs. 15.9 +/- 4.2 mm Hg in the glaucoma and non-glaucoma groups, respectively (P=.35). At three months postoperatively, the non-glaucoma group had a significantly lower IOP compared to the glaucoma group, 14.6 +/-3.3 mm Hg vs. 16.5 +/- 5.8 mm Hg, respectively (P=.035). However, at 12 months, IOP in the glaucoma group, 15.2 +/- 3.5, was similar to patients without glaucoma, 15.0 +/- 3.7 (P=.66). In the glaucoma group, there was no change in number of glaucoma medications preoperatively, 1.23 +/- 1.1, and at one year, 1.23 +/- 1.05 (P=.56).
When performing cataract surgery on glaucoma patients, be cautious of rises in IOP in the first few months postoperatively. However, at 12 months, IOP for glaucoma patients is significantly lower than the preoperative value with no change in number of glaucoma medications and IOP is similar to the non-glaucoma group.
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