May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Intraocular Pressure Changes and Glaucoma in Patients Undergoing Pars Plana Lensectomy and Vitrectomy for Retained Lens Material after Complicated Cataract Extraction
Author Affiliations & Notes
  • M. Kirzhner
    Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, Michigan
  • Y. Shildkrot
    Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, Michigan
  • J. E. Puklin
    Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, Michigan
  • R. Iezzi
    Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, Michigan
  • D. Eliott
    Ophthalmology, Doheny Retina Institute, Los Angeles, California
  • G. W. Abrams
    Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, Michigan
  • T. H. Mahmoud
    Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, Michigan
  • Footnotes
    Commercial Relationships  M. Kirzhner, None; Y. Shildkrot, None; J.E. Puklin, None; R. Iezzi, None; D. Eliott, None; G.W. Abrams, None; T.H. Mahmoud, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 4167. doi:https://doi.org/
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      M. Kirzhner, Y. Shildkrot, J. E. Puklin, R. Iezzi, D. Eliott, G. W. Abrams, T. H. Mahmoud; Intraocular Pressure Changes and Glaucoma in Patients Undergoing Pars Plana Lensectomy and Vitrectomy for Retained Lens Material after Complicated Cataract Extraction. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4167. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To determine factors affecting intraocular pressure (IOP) and the need for glaucoma surgery in patients undergoing pars plana lensectomy and vitrectomy (PPL/V) for retained lens materials.

Methods: : A retrospective chart review was conducted of patients who underwent PPL/V between 2000 and 2007. Patients with no history of cataract extraction (CE), follow-up of less than 30 days, or a recent history of severe globe trauma requiring PPL/V were excluded.

Results: : We identified 118 consecutive patients, 64 males and 54 females, who were entered into the study. Mean age at the time of PPL/V was 69.7 ± 12 years (range 21 to 92 years) with a mean follow-up of 523 ± 512 days (range 32 to 2611 days). IOP increased following cataract extraction by a mean of 13.4 mmHg from a mean of 17.3 to a mean maximum IOP (Tmax) of 30.7 mm Hg (2-tailed t-test, p<0.0001), which then improved following PPL/V to a mean Tmax of 24.4 (2-tailed t-test, p < 0.0001). IOP continued to improve and by the last visit, the mean IOP was similar to pre-cataract extraction pressure (2-tailed t-test, p > 0.76). Pre-existing diagnosis of glaucoma or glaucoma suspect was associated with a higher mean Tmax following PPL/V (27.5 ± 1 vs. 22.6 ± 1, ANOVA, p = 0.0078), need for glaucoma surgery (6/44, 13.6% vs. 1/74, 1.35%, Pearson, p = 0.0063), and longer duration of glaucoma drops use (222 ± 49 vs. 58 ± 39 days, ANOVA, p = 0.0102). While pre-cataract extraction IOP was higher in patients with established or suspected glaucoma (ANOVA, p = 0.0048), at the end of the follow-up, IOP was similar in the two groups (ANOVA, p > 0.7). The final visual acuity was not affected by pre-existing history of glaucoma or glaucoma suspect.

Conclusions: : PPL/V for retained lens material is associated with better control of IOP. Pre-existing glaucoma or a diagnosis of glaucoma suspect may predispose to a more difficult control of IOP following PPL/V and an increased need for glaucoma surgery.

Keywords: intraocular pressure • intraocular lens • treatment outcomes of cataract surgery 
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