Long-term effects of phacoemulsification surgery on intraocular pressure in patients with primary open-angle glaucoma and pseudoexfoliation glaucoma
Long-term effects of phacoemulsification surgery on intraocular pressure in patients with primary open-angle glaucoma and pseudoexfoliation glaucoma
Aim: To compare the long-term effects of phacoemulsification surgery on intraocular pressure (IOP) in primary open-angle glaucoma(POAG) and pseudoexfoliation glaucoma (PXG) patients.Material and Methods: This is a retrospective-comparative study. The data of the patients who underwent phacoemulsificationsurgery by the same surgeon between 2010 and 2016 and followed up more than 24 months postoperatively were collected. Whilegroup 1 consisted of 24 patients with POAG group 2 consisted of 16 patients with PXG. Preoperative, postoperative 1st day, 1st, 12th,18th, 24th, 36th and 48th months IOP and best corrected visual acuity (BCVA) were enrolled.Results: The mean follow-up time of group 1 was 44.17 ± 17.8 months and 43.13 ± 19.4 months for group 2 (p= 0.86). There wasno statistically significant difference between the groups in the preoperative, postoperative 1st day, 1st, 12th, 18th, 36th and 48thmonths IOP (p>0.05). There was a statistically significant difference for the IOP value measured postoperative 24th month betweenthe groups (p= 0.005). There was a statistically significant difference between preoperative and postoperative 1st, 12nd months IOPmeasurements in group 1 (p= 0.02; p= 0.009, respectively). There was a statistically significant difference between preoperative andpostoperative 24th months IOP measurements in group 2 (p=0.01).Conclusion: Although phacoemulsification surgery may cause an increase (14-19 %) in IOP early postoperative period in eyes withPOAG and PXG, may provide a modest level decreases (19-18 %) in the long term.
___
- 1. Iancu R, Corbu C. Intraocular pressure after phacoemulsification in patients with uncontrolled primary open angle glaucoma. J Med Life 2014;7:11- 6.
- 2. Hayashi K, Hayashi H, Nakao F, et al. Effect of cataract surgery on intraocular pressure control in glaucoma patients. J Cataract Refract Surg 2001;27:1779-86.
- 3. Shrivastava A, Singh K. The effect of cataract extraction on intraocular pressure. Curr Opin Ophthalmol 2010;21:118-22.
- 4. Kronberg BP, Rhee DJ. Anterior segment imaging and the intraocular pressure lowering effect of cataract surgery for open and narrow angle glaucoma. Semin Ophthalmol 2012;27:149-54.
- 5. Chen PP, Lin SC, Junk AK, et al. The Effect of Phacoemulsification on Intraocular Pressure in Glaucoma Patients: A Report by the American Academy of Ophthalmology. Ophthalmology 2015;122:1294- 307.
- 6. Shingleton BJ, Pasternack JJ, Hung JW, et al. Three and five year changes in intraocular pressures after clear corneal phacoemulsification in open angle glaucoma patients, glaucoma suspects, and normal patients. J Glaucoma 2006;15:494-8.
- 7. Kingman S. Glaucoma is second leading cause of blindness globally. Bull World Health Organ 2004;82:887-8.
- 8. Tham YC, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 2014;121:2081-90.
- 9. Prum BE Jr, Rosenberg LF, Gedde SJ, et al. Primary Open-Angle Glaucoma Preferred Practice Pattern(®) Guidelines. Ophthalmology 2016;123:41-111.
- 10. Jonas JB, Budde WM, Panda Jonas S. Ophthalmoscopic evaluation of the optic nerve head. Surv Ophthalmol 1999;43:293-320.
- 11. Merkur A, Damji KF, Mintsioulis G, et al. Intraocular pressure decrease after phacoemulsification in patients with pseudoexfoliation syndrome. J Cataract Refract Surg 2001;27:528-32.
- 12. Ritch R, Schlotzer Schrehardt U. Exfoliation syndrome. Surv Ophthalmol 2001;45:265-315.
- 13. Kuchle M, Amberg A, Martus P, et al. Pseudoexfoliation syndrome and secondary cataract. Br J Ophthalmol 1997;81:862-6.
- 14. Schlotzer-Schrehardt U, Naumann GO. Ocular and systemic pseudoexfoliation syndrome. Am J Ophthalmol 2006;141:921-37.
- 15. Tarkkanen AH, Kivela TT. Comparison of primary open-angle glaucoma and exfoliation glaucoma at diagnosis. Eur J Ophthalmol 2015;25:137-9.
- 16. Elgin U, Sen E, Simsek T, et al. Early Postoperative Effects of Cataract Surgery on Anterior Segment Parameters in Primary Open-Angle Glaucoma and Pseudoexfoliation Glaucoma. Turk J Ophthalmol 2016;46:95-8.
- 17. McKellar MJ, Elder MJ. The early complications of cataract surgery: is routine review of patients 1 week after cataract extraction necessary? Ophthalmology 2001;108:930-5.
- 18. Ahmed II, Kranemann C, Chipman M, et al. Revisiting early postoperative follow-up after phacoemulsification. J Cataract Refract Surg 2002;28:100-8.
- 19. Grzybowski A, Kanclerz P. Early postoperative intraocular pressure elevation following cataract surgery. Curr Opin Ophthalmol 2019;30:56-62.
- 20. Slabaugh MA, Bojikian KD, Moore DB, et al. Risk factors for acute postoperative intraocular pressure elevation after phacoemulsification in glaucoma patients. J Cataract Refract Surg 2014;40:538-44.
- 21. Jimenez RJ, Lazcano GG, Martinez BK, et al. Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma pseudoexfoliation glaucoma. Int J Ophthalmol 2017;10:1374-8.
- 22. Mierzejewski A, Eliks I, Kaluzny B, et al. Cataract phacoemulsification and intraocular pressure in glaucoma patients. Klin Oczna 2008;110:11-7.
- 23. Mathalone N, Hyams M, Neiman S, et al. Long-term intraocular pressure control after clear corneal phacoemulsification in glaucoma patients. J Cataract Refract Surg 2005;31:479-83.
- 24. Damji KF, Konstas AG, Liebmann JM, et al. Intraocular pressure following phacoemulsification in patients with and without exfoliation syndrome: a 2 year prospective study. Br J Ophthalmol 2006;90:1014-8.
- 25. Meyer MA, Savitt ML, Kopitas E. The effect of phacoemulsification on aqueous outflow facility. Ophthalmology 1997;104:1221-7.
- 26. Epstein DL, Hashimoto JM, Grant WM. Serum obstruction of aqueous outflow in enucleated eyes. Am J Ophthalmol 1978;86:101-5.
- 27. Perasalo R. Phaco-emulsification of cataract in eyes with glaucoma. Acta Ophthalmol Scand 1997;75:299- 300.
- 28. Slabaugh MA, Bojikian KD, Moore DB, et al. The effect of phacoemulsification on intraocular pressure in medically controlled open-angle glaucoma patients. Am J Ophthalmol 2014;157:26-31.
- 29. Altan YR, Canan H, Pelit A, et al. Intraocular pressure after phacoemulsification in eyes with pseudoexfoliation. J Cataract Refract Surg 2009;35:952-4.