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Abstract #67602 Published in IGR 17-4
Intra-ocular pressure fluctuation after cataract surgery in primary angle-closure glaucoma eyes medically controlled after laser iridotomy
Özyol P; Özyol E; Sül S; Baldemir E; Çavdar SActa Ophthalmologica 2016; 94: e528-e533
PURPOSE: To analyse the effect of cataract surgery on diurnal intra-ocular pressure (IOP) fluctuation in primary angle-closure glaucoma (PACG) eyes. METHODS: Thirty-nine eyes of 24 patients with PACG scheduled for cataract surgery were enrolled to this prospective study. A record was made which included mean IOP measurement, anterior chamber depth (ACD), anterior chamber angle (ACA), number of antiglaucomatous medications, visual field analysis (mean deviation - MD and pattern standard deviation - PSD) and responses to the Glaucoma Quality of Life-15 (GQL-15) questionnaires. The eyes were re-evaluated at 2 and 3 months of cataract surgery. RESULTS: IOP fluctuation was decreased from 4.58 ± 2.07 mmHg to 2.84 ± 1.5 mmHg (p < 0.001). The decrease in mean IOP, the number of glaucoma eye drops required (p < 0.001, p = 0.012, respectively) and the increase in mean ACD, ACA grading and SITA-standard MD (p < 0.001, p < 0.001, and p = 0.01, respectively) were statistically significant. The mean GQL-15 score was also improved (p < 0.001). The change in IOP fluctuation correlated positively with the preoperative IOP fluctuation (r = 0.56 p = 0.00), the change in ACD (r = 0.703, p < 0.001) and the change in ACA (r = 0.664, p < 0.001). In multivariate analysis, preoperative IOP fluctuation and postoperative increase in ACD were significantly associated with a reduction in IOP fluctuation of an average of 1.1 mmHg per unit change (p = 0.00 and p = 0.019, respectively). CONCLUSIONS: Cataract surgery in PACG provides the opportunity to address many pathologies with one intervention; improving vision, diminishing IOP, blunting IOP fluctuation, reducing need for medications, eliminating a narrow angle and improving GQL-15 scores.
Department of Ophthalmology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
Full articleClassification:
9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
12.2 Laser iridotomy (Part of: 12 Surgical treatment)
6.1.3 Factors affecting IOP (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)