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Effect of phacoemulsification cataract surgery on intraocular pressure in early glaucoma: a prospective multi-site study
Citation
Qassim, A and Walland, MJ and Landers, J and Awadalla, M and Nguyen, T and Loh, J and Schulz, AM and Ridge, B and Galanopoulos, A and Agar, A and Hewitt, AW and Graham, SL and Healey, PR and Casson, RJ and Craig, JE, Effect of phacoemulsification cataract surgery on intraocular pressure in early glaucoma: a prospective multi-site study, Clinical and Experimental Ophthalmology, 48, (4) pp. 442-449. ISSN 1442-6404 (2020) [Refereed Article]
Copyright Statement
Copyright 2020 Royal Australian and New Zealand College of Ophthalmologists
Abstract
Background: Previous studies exploring the effect of cataract surgery on IOP are limited by retrospective design, lack of a control group, medication use and washout and loss to follow up.
Design: Prospective, multicentre, matched case-control Australian study.
Participants: 171 eyes of 108 POAG patients who underwent cataract surgery, matched to 171 control eyes.
Methods: Serial longitudinal IOP measurements were compared before and after cataract surgery, and relative to the controls. A mixed-effect model was used for the longitudinal data.Main Outcome Measures: Change in IOP.
Results: The mean follow-up time was 4.8 (1.4) years. Cataract surgery reduced mean IOP by 2.22 mmHg (95% confidence interval: 1.93-2.52 mmHg, P < .001) with 59 eyes (34%) achieving at least 3 mmHg reduction. Compared to matched controls, the mean reduction in IOP was 1.75 mmHg (95% confidence interval 1.15-2.33 mmHg; P < .001). Higher preoperative IOP and being on fewer topical glaucoma medications preoperatively were strongly predictive of a larger IOP reduction in a multivariable model. Anterior chamber depth was not associated with IOP reduction. Eyes with preoperative IOP ≥24 mmHg had a mean IOP reduction of 4.03 mmHg with 81% experiencing at least 3 mmHg reduction. Sub-analysis of medication naïve and pseudoexfoliation patients showed similar results.
Conclusions and Relevance: Cataract surgery has a confirmed effect in reducing IOP in a "real world" setting of early glaucoma patients.
Item Details
| Item Type: | Refereed Article |
|---|---|
| Keywords: | biometry, cataract, cataract surgery, open-angle glaucoma, phacoemulsification |
| Research Division: | Biomedical and Clinical Sciences |
| Research Group: | Ophthalmology and optometry |
| Research Field: | Ophthalmology |
| Objective Division: | Health |
| Objective Group: | Clinical health |
| Objective Field: | Clinical health not elsewhere classified |
| UTAS Author: | Hewitt, AW (Professor Alex Hewitt) |
| ID Code: | 138809 |
| Year Published: | 2020 |
| Web of Science® Times Cited: | 5 |
| Deposited By: | Menzies Institute for Medical Research |
| Deposited On: | 2020-04-30 |
| Last Modified: | 2021-04-26 |
| Downloads: | 0 |
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