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Glaucoma severity and intraocular pressure reduction after cataract surgery in eyes with medically controlled glaucoma

Authors
Yoo, ChungkwonAmoozgar, BehzadYang, Kyung-SookPark, Ji-HyeLin, Shan C.
Issue Date
10월-2018
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Keywords
cataract surgery; glaucoma; intraocular pressure; phacoemulsification
Citation
MEDICINE, v.97, no.42
Indexed
SCIE
SCOPUS
Journal Title
MEDICINE
Volume
97
Number
42
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/72665
DOI
10.1097/MD.0000000000012881
ISSN
0025-7974
Abstract
To investigate the relationship between glaucoma severity and intraocular pressure (IOP) reduction after cataract surgery in patients with medically controlled primary open-angle glaucoma (POAG). Retrospective case series. This study included glaucoma suspects (GS) and POAG patients who underwent cataract surgery and continued to use the same glaucoma medications during the postoperative period of 4 months. The main outcomes were percent and absolute IOP changes calculated using the preoperative IOP and the postoperative IOP at 3 months. Preoperative glaucoma medications, preoperative IOP, demographic information, biometric parameters and variables for glaucoma severity were evaluated as potential predictors of IOP change. The average IOP reduction was 3.3 +/- 2.4 mmHg (20.0%) and 2.2 +/- 2.5 mmHg (13.1%) from the preoperative mean of 16.0 +/- 2.9 mmHg and 15.2 +/- 3.3 mmHg in the GS and POAG groups, respectively. Preoperative IOP, preoperative IOP/anterior chamber depth (preoperative IOP/ACD [PD ratio]) and preoperative IOP/retinal nerve fiber layer (RNFL) thickness (preoperative IOP/RNFL [PNFL ratio]) and preoperative IOP score xMD score x number of glaucoma medications (glaucoma index) predicted absolute IOP change in the POAG group, whereas preoperative IOP, PD ratio, PNFL ratio, and axial length (AL) did in the GS group. Preoperative IOP, PD ratio, and PNFL ratio predicted %IOP change in the POAG group, whereas only AL did in the GS group. In medically controlled POAG eyes, structural or functional parameters for glaucoma severity did not independently predict IOP change following phacoemulsification. However, novel severity indices obtained by addition of preoperative IOP and/or glaucoma medications to the structural or functional parameter predicted IOP changes.
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