Abstract
Purpose :
Several reports have suggested that cataract surgery can reduce intraocular pressure (IOP) in eyes either with or without glaucoma, although IOP reduction varies in magnitude due to a diversity of factors. The aim of this study is to investigate the effect of phacoemulsification + IOL implantation (phaco+IOL) on the post-operative IOP in three different clinical conditions.
Methods :
From a retrospective clinical data analysis of 137 eyes of 137 patients who underwent cataract surgery at a glaucoma specialized center in Western Mexico between the period of June 2015 and October 2018, 91 cases met the inclusion criteria. Thirty-eight of these cases had age-related cataract (ARC), 22 had either mild primary angle-closure glaucoma or primary closed/occludable irido-corneal angles (CSD), and 31 had either mild open-angle glaucoma or open-angle glaucoma suspicion (OPN). General information, BCVA, biometry (axial length -AL- and anterior chamber depth -ACD), number of antiglaucoma medications, vertical cup/disc ratio, and IOP were pre-operatively collected. Main post-operative variables were BCVA, IOP and number of antiglaucoma medications at day 1, month 1, month 3 and month 6.
Results :
When compared with baseline values, mean BCVA in the final visit improved similarly in the 3 groups (P<0.05). Mean AL and ACD values were significantly lower in the CSD group when compared to the ARC and OPN groups (P=0.0018 and P=0.003, respectively). Pre-operative mean IOP was different among the three groups (ARC,13.18 ± 2.68 mm Hg; OPN, 15.83 ± 2.80 mm Hg; CSD, 17.04 ± 3.16 mm Hg). Post-operative IOP reduction in all visits was lower in the CSD group as compared to baseline pressure (P<0.05; repeated measures ANOVA). The number of glaucoma medications decreased only in the CSD group at the 3-month and 6-month visits (P=0.037 and P=0.022, respectively). No correlations were found when both AL and ACD were analyzed against IOP.
Conclusions :
This report confirms that cataract surgery, especially in persons with narrow/closed angles is prone to induce remarkable reductions of IOP. Eyes with different anatomical architectures have less reproducible reductions of IOP.
This is a 2020 ARVO Annual Meeting abstract.