Abstract
Purpose :
To evaluate the effect of small incision phacoemulsification on intraocular pressure (IOP) of patients with primary open angle glaucoma (POAG)
Methods :
We retrospectively reviewed the charts of 353 patients who had small incision phacoemulsification cataract surgery between 2017 and 2018 and identified patients who had a diagnosis of POAG for further analysis. All procedures were performed by the same surgeon using the same technique. Patients with complicated cataract surgery or a history of incisional glaucoma surgery were excluded from the analysis. The study population is composed of 30 eyes from 26 patients who had stable glaucoma treated with medication, laser, or a combination of both prior to cataract surgery.
We defined preoperative IOP as the average of up to 3 IOP measurements in the 18 months period prior to cataract surgery and postoperative IOP as the average of up to 3 postoperative IOP measurements 2 to 18 months after surgery. Age, race, sex, eye laterality, number of pre-operative and post-operative glaucoma medications, and history of glaucoma laser were recorded for all patients.
Results :
The age mean +/- standard deviation (SD) was 71.53 +/- 9.13 years. The patients were mostly male (63.33%) with a small predominance of Caucasians compared to African Americans (56.67% vs. 43.33%). Right and left eyes were equally distributed (50%) and 70% of the patients had a history of glaucoma laser treatment. After confirming the normality assumption, paired t-test was performed for the difference between preoperative and postoperative data. The IOP (mean +/- SD) was decreased from 15.17 +/- 2.77 mmHg preoperatively to 14.00 +/- 2.40 mmHg postoperatively (p < 0.001). Twenty-one patients had an IOP reduction (range 1-5 mmHg), one patient’s IOP remained unchanged, and 8 patients had an increase in IOP (range 1-2 mmHg). The number of IOP-lowering eye drops decreased from 0.73 to 0.67 which was not statistically significant.
Conclusions :
In this study, uncomplicated small-incision phacoemulsification resulted in a small but statistically significant reduction in IOP on average in patients with POAG. Interestingly, some patients experienced small increases in IOP after surgery. Further studies are needed to evaluate clinical parameters that could explain this observation.
This is a 2021 ARVO Annual Meeting abstract.