To investigate the effect of cataract surgery by phacoemulsification on intraocular pressure (IOP) in patients with medically POAG
Seventy eyes of 40 POAG patients undergoing cataract surgery by phacoemulsification were retrospectively evaluated before and for 1 year after cataract surgery
One year after phacoemulsification, IOP decreased by a mean 1.15 ± 3 mmHg (6.8 ± 18.1%) (P = 0.01) and the number of glaucoma medications remained unchanged with a difference of - 0.1 ± 0.43 (P = 0.09).
Higher preoperative IOP was associated with a greater IOP decrease after 1 year of follow-up (P < 0.001). One and 7 days after cataract surgery, 12.9 and 4.2% of the eyes had IOP spikes > 30 mmHg, respectively.
One year after cataract surgery, 75.7% of the POAG eyes maintained the same number of glaucoma medications while 17.1% had a decrease and 7.2% of the eyes required adding glaucoma medications.
Cataract surgery by phacoemulsification in eyes with medically controlled POAG resulted at 1 year in a very small IOP decrease without a change in the number of glaucoma medications.
A drop in IOP should not be expected after performing phacoemulsification alone in POAG patients.
TAKE HOME MESSAGE
In patients with primary open-angle glaucoma (POAG) controlled on medication, the authors retrospectively evaluated the effect of cataract surgery on intraocular pressure.
They found that, after phacoemulsification for visually significant cataract, 5% of the total 70 eyes included in the study had an increase in IOP of >5 mm Hg, 8% of the eyes had a decrease in IOP of >5 mm Hg, and 87% of the eyes had stable IOP with no change in glaucoma medications at 1 year of follow-up.
Cataract surgery in eyes with POAG is not expected to lower IOP and could instead lead to immediate postoperative spikes as well as a sustained increase.
BMC Ophthalmol 2019 Jul 12;19(1)149
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