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Zoey Stoumbos, Deborah Wilson; The Effect of Phacoemulsification on Intraocular Pressure in Glaucoma Patients in Resident Cases. Invest. Ophthalmol. Vis. Sci. 2018;59(9):449.
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Phacoemulsification has been well shown to lower intraocular pressure (IOP) for many patient populations for up to 2-3 years post-operatively. To the best of our knowledge, it has not been studied if this trend is true for resident cases, which tend to have longer operating times and higher rates of short term IOP spikes. The purpose of this study is to examine the effect that phacoemulsification has on IOP in patients with glaucoma undergoing uncomplicated cataract surgery performed by residents, as well as examining if the number of IOP-lowering medications is affected by having phacoemulsification or not.
A retrospective chart review is being conducted looking at patients with the diagnosis of any open angle glaucoma (including normal tension, pseudoexfoliation, and pigment dispersion), ocular hypertension, or glaucoma suspect, who underwent uncomplicated cataract surgery at Washington Hospital Center by residents from 2000 to 2015. Exclusion criteria include secondary causes of glaucoma or a history of glaucoma surgery/combined procedures. Collected data includes pre-operative IOP, post-operative IOP at day 1, week 1, month 1, year 1, and at last follow up, and the number of IOP-lowering medications needed both pre- and post-operatively. Student's t-test will be used for statistical analysis.
Charts of 953 patients with ICD9 codes corresponding to glaucoma diagnoses and undergoing cataract surgery (CPT codes 66982 and 66984) are being examined. Preliminary data suggests that lowering of IOP after phacoemulsification is presents in resident cases, but that this effect is maximal at post-operative month 6, and by post-operative year 1.5, there is no longer a statistically significant reduction in IOP. Data collection and analysis is still underway.
Phacoemulsification is one of the most commonly performed surgeries in this country, and has been well shown to have a long-term effect on IOP. Our preliminary data suggests that this effect may not be as robust for cases performed by residents as it is for cases performed by more experienced surgeons, and continued data collection and analysis will help to further clarify this. As many patients that residents operate on have comorbid glaucoma and cataracts, a better understanding of the effect of phacoemulsification on IOP can help us better counsel our patients pre- and post-operatively.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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