Purchase this article with an account.
L. M. Rossetti, P. Fogagnolo, A. M. Fea, M. Centofanti, M. Figus, P. Frezzotti, U. Lorenzi, G. Roberti, N. Orzalesi; Short-Term Iop Changes After Phacoemulsification in Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2010;51(13):597.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
1. to evaluate short-term IOP changes after phacoemulsification in glaucomatous patients; 2. to evaluate the effect of systemic acetazolamide in controlling post-cataract peaks of IOP.
Included were patients with OAG well controlled by medical therapy (IOP < 21mmHg) who needed a cataract extraction through phacoemulsification. Patients underwent a standard phaco procedure (temporal incision 2.7-3.2 mm, devide and conquer or chop technique, injectable lens implantation, accurate viscolelastic removal above and under the lens, acetylcholine in the AC at the end of the procedure) and were checked for IOP with Goldmann tonometry in the morning before surgery and then at 3, 6, 21 and 24 hours after phacoemulsification. A group of non-glaucomatous patients matched for age, type of cataract and undergoing cataract surgery were assessed as controls. A different group of glaucomatous subjects received acetazolamide 250 mg p.o. 1 and 6 hours after surgery.
The group with OAG (30 patients) had a mean pre-operative IOP of 17.5 (sd, 2.3 mmHg) and after phaco showed a statistically significant increase in IOP (p<0.001): 25.8 (sd, 3.5 mmHg) after 3 hours, 26.7 (sd, 4.2 mmHg) after 6 hours, 30.0 (sd 4.6 mmHg) after 21 hours and 27.1 (sd, 3.8 mmHg) at 24 hours from cataract extraction. All cases showed an IOP above 21 mmHg at all time points. The control group (30 patients) had similar pre-operative IOPs (16.6, sd, 2.1 mmHg) and showed IOP above 21 mmHg in at least one time point in 20% of cases. In the OAG group receiving acetazolamide (30 patients) only 10 patients had IOP above 21 mmHg at all time points.
A significant short-term increase in IOP can be observed after phaco in OAG patients. Treatment with acetazolamide may obtain a partial IOP control in some patients.
This PDF is available to Subscribers Only