Abstract
Purpose :
To use anterior segment optical coherence tomography (AS-OCT) to evaluate anatomical predictors of intraocular pressure drop one year after phacoemulsification in glaucomatous eyes without angle closure.
Methods :
This was a prospective study of consecutively enrolled glaucoma patients who had cataract surgery between July 2009 and July 2015. Patients were screened and enrolled at the University of California, San Francisco Medical Center. Patients with a diagnosis of glaucoma but without peripheral anterior synechiae (PAS), pigment dispersion, pseudoexfoliation, other secondary causes of glaucoma, prior surgery or trauma were included. Subjects received AS-OCT prior to and 1 year after phacoemulsificaton cataract surgery. Intraocular pressure by Goldmann applanation was checked by a single, masked observer in the early afternoon on all study visits. Subjects were kept on the same glaucoma regimen as prior to surgery. The main outcome was intraocular pressure change at 1 year compared to baseline. Predictors were the following anterior segment parameters: 1) anterior chamber depth (ACD); 2) lens vault (LV); and 3) anterior chamber volume (ACV). Mixed effects regression, adjusting for gender, age, race and central corneal thickness was performed to correlate the main outcome with the AS- OCT parameters.
Results :
We enrolled 189 eyes from 139 subjects. The mean age of all participants was 75 ± 8 years and a majority were women (63%). The mean IOP drop was 2.9 ± 3 mmHg in the entire group. When correcting for age, gender, and CCT, there was a significant correlation with IOP reduction with ACD (β 0.22, p =0.05), (ACV (β 0.011, p=0.01) and LV (β 0.003, p=0.04).
Conclusions :
There is a significant IOP reduction in our cohort of glaucoma subjects. This reduction was correlated with ACD, ACV, and LV—parameters which may be helpful predictors in glaucoma subjects.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.