Abstract
Abstract: :
Purpose:To compare the postoperative intraocular pressure (IOP) reduction in both normal and glaucomatous eyes after clear cornea, small incision, cataract surgery. Methods: We reviewed the consecutive charts of seventy–six patients undergoing topical, temporal, clear cornea phacoemulsification and intraocular lens implantation by a single surgeon (RKS) between January 2003 and August 2003. Eyes were classified as either normal or glaucomatous based on their preoperative glaucoma medication usage of at least one agent. A database was created that included demographics, medical history, pre– and postoperative refraction and visual acuities, A– scan measurements, IOP (pre– and postoperative day 1, 1 week, and 1 month) and medication usage. Patients were excluded if they had surgical complications (one zonular dehiscence), previous glaucoma surgery (none), or insufficient follow–up of at least one month (one). Results: Fifty–seven normal eyes were studied and had a baseline IOP of 14.1 ± 3.2 mm Hg, an IOP of 13.7 ± 2.8 mm Hg at postoperative one month with an IOP reduction of –0.4 ± 3.1 mm Hg (p = 0.37). Nineteen glaucoma patients had a baseline IOP of 16.6 ± 3.6 mm Hg, a one month IOP of 13.3 ± 2.3 mm Hg and an IOP reduction of –3.4 ± 3.2 mm Hg (p = 0.0002). The difference in IOP reduction was significant (p = 0.0006) between the two groups. The average medication usage at baseline in the glaucoma patients was 1.1 ± 0.2 drops and at 1 month post–op was 0.4 ± 0.5 (p = 0.0002). ) The only significant difference in baseline values between the groups (other than glaucoma medications) was the anterior chamber depth (ACD). Normal patients had an ACD of 3.2 ± 0.4 mm and glaucoma patients had an ACD of 2.9 ± 0.5 mm (p = 0.015). Linear regression did not find a significant correlation coefficient between ACD and 1 month IOP reduction in either group. One normal and one glaucomatous eye had an elevated IOP greater than 25 mm Hg on postoperative day one and these were both reduced under 21 mm Hg by the first week with medications. Conclusions:One month after clear cornea, small incision, cataract surgery, glaucoma patients had more IOP reduction than normal patients with less postoperative medication usage.
Keywords: small incision cataract surgery • treatment outcomes of cataract surgery • intraocular pressure