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A.C. Crichton, J.Y. Wong; The Effect of Phacoemulsification and Intraocular Lens Implantation in Patients With Prior Relief of Pupillary Block by Laser Iridotomy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):141.
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Purpose: To evaluate intraocular pressure (IOP) response following phacoemulsification and intraocular lens (IOL) implantation in patients who have had previous laser iridotomy. Methods: We conducted a retrospective case review of patients who had undergone phacoemulsification and IOL implantation who had a history pupillary block relieved by laser iridotomy. A total of 37 eyes from 32 patients were included in the final analysis. Patients were excluded if they had undergone previous IOP lowering surgery, existing ocular disease affecting IOP or insufficient follow–up of three months. The main outcome measures were IOP, IOP controlling medications and postoperative complications. Results: After phacoemulsification, intraocular pressure was less than 20 mm Hg in 33/37 eyes (89.2%) with or without IOP–lowering medication compared to 15/37 eyes (40.5%) preoperatively. Mean postoperative IOP was significantly lower, 15.6 ± 3.0 mm Hg, than mean preoperative IOP, 19.7 ± 2.9 mm Hg (P< 0.001). There was also significant reduction in the number of IOP lowering medications from 1.38 ± 1.14 to 0.57 ± 0.73 (P <0.001). A reduction in IOP of ≥ 3mm Hg was achieved in 28/37 eyes (75.7%). In two patients, additional IOP–lowering surgery was required. In one patient, an acute rise in IOP postoperatively was controlled with anti–inflammatory medications and steroid medication. Conclusions: Phacoemulsification and IOL implantation appears to provide a significant reduction in IOP in patients with a prior history of pupillary block.
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