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David Andrew Terrell, Meenakshi Chaku, Brian R Sullivan; Postoperative Intraocular Pressure Dynamics after Femtosecond Assisted Cataract. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3744. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Femtosecond laser assisted cataract surgery (FLACS) has been shown to transiently increase intraocular pressure (IOP) in patients undergoing cataract surgery. Limited studies have examined the impact of FLACS on patient’s postoperative intraocular pressure; and more specifically, patients identified to have glaucoma or pre-glaucoma. The purpose of this study is to investigate postoperative intraocular pressure dynamics after femtosecond laser-assisted cataract surgery (FLACS) as compared to incisional cataract surgery. We hypothesize that current FLACS techniques will result in increased postoperative pressures, insofar as utilization of FLACS commonly results in increased time of surgery and is known to transiently increase intraocular pressure.
In this IRB approved prospective study, we have analyzed 41 patients that underwent FLACS vs 39 patients that underwent traditional incisional surgery from September of 2014 through May of 2015 at Hines Hospital of Veterans Affairs. Primary outcome measurements included pre- and post-operative IOP, as well as number of glaucoma medications the patients were on pre and post-operatively.
This study identified an increase in intraocular pressure for the subset of patients identified to have pre-glaucoma or POAG after FLACS at post-operative day one and week one; as compared to the similar patient population that underwent traditional cataract surgery (e.g. 14.89 mmHg +/- 2.9 (p=0.0494), 4.1 mmHg +/- 3.17 (p= 0.24) at post op day 1 and week 1 respectively). A trend towards an increase in the number of glaucoma medications was also observed in the FLACS groups, with pre- /post-operative glaucoma medication ratios of 1.2/1.6, but the difference was not statistically significant (p=0.42). Whereas there was no statistical difference of post-operative intraocular pressure in non-glaucomatous patients who underwent FLACS or traditional cataract surgery.
In this study we prospectively examined multiple pre- and post-operative time points, (including post op day 1, post op week 1, post op month 1 and 6 months). We have found that FLACS results in statistically higher post-operative intraocular pressure in the glaucoma/preglaucoma subset of cataract surgery patients, as compared with traditional cataract surgery.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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