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Abstract #47716 Published in IGR 13-4
Preoperative iris configuration and intraocular pressure after cataract surgery
Pradhan S; Leffler CT; Wilkes M; Mahmood MAJournal of Cataract and Refractive Surgery 2011;
Purpose: To determine predictors of long-term intraocular pressure (IOP) after cataract surgery. Setting: Hunter Holmes McGuire Veterans Administration Hospital, Richmond, Virginia, USA. Design: Case series. Methods: Clinical variables, IOP by applanation tonometry, anatomic features on anterior segment optical coherence tomography (AS-OCT), and gonioscopy were assessed before and after uneventful cataract surgery in eyes with open filtration angles. Multivariate linear regression of preoperative measurements was used to predict the mean IOP from 2 to 18 months postoperatively. Results: The study enrolled 77 eyes (77 patients). Prediction of the mean postoperative IOP improved when up to 4 preoperative IOP values were averaged (r( 2) = 0.20) compared with using the final preoperative IOP value only (r( 2) = 0.13). The mean iris cross-sectional area decreased after surgery, from 3.84 mm(2) to 3.70 mm(2) (P=.01). The mean convex hull of the iris segments also decreased, from 5.05 mm(2) to 4.19 mm(2) (P<.001). The mean postoperative IOP was independently predicted by the preoperative average IOP, primary open-angle glaucoma, and the convex hull of cross-sectional iris segments (P=.001, model r( 2) = 0.38) or iris cross-sectional area (P=.003, model r( 2) = 0.36). Phacoemulsification parameters, incision type, and anterior chamber angle and depth did not predict postoperative IOP. Conclusions: Averaging up to 4 preoperative IOP values improved postoperative IOP predictions. A high iris cross-sectional area or convex hull of the iris segments on AS-OCT was associated with lower postoperative IOP. These findings might help identify patients who are likely to have the largest IOP drop after cataract surgery. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (copyright) 2011 ASCRS and ESCRS.
C.T. Leffler. From the Ophthalmology Section (Pradhan, Leffler, Mahmood), Hunter Holmes McGuire Veterans Administr, . Email: cleffler@pol.net
Classification:
9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
2.8 Iris (Part of: 2 Anatomical structures in glaucoma)
