advertisement
Abstract #74800 Published in IGR 19-1
The Effects of Phacoemulsification and Intraocular Lens Implantation on Anatomical and Functional Parameters in Patients with Primary Angle Closure: A Prospective Study. (An American Ophthalmological Society Thesis)
Traverso CE; Cutolo CATransactions of the American Ophthalmological Society 2017; 115: T7
PURPOSE: To investigate the clinical, anatomical, and patient-reported outcomes of phacoemulsification (PE) with intraocular lens implantation performed to treat primary angle closure (PAC) and primary angle-closure glaucoma (PACG). METHODS: Patients were evaluated at baseline and at 6 months after PE. The examination included visual acuity, intraocular pressure (IOP), visual field, optic nerve head, endothelial cell count (ECC), aqueous depth, and ocular biometric parameters. Patient-reported visual function and health status were assessed. Coprimary outcome measures were IOP changes, angle widening, and patient-reported visual function; secondary outcome measures were visual acuity changes, use of IOP-lowering medications, and complications. Univariate and multivariate analyses were performed to determine the predictors of IOP change. RESULTS: Thirty-nine cases were identified, and postoperative data were analyzed for 59 eyes, 39 with PACG and 20 with PAC. Globally, PE resulted in a mean reduction in IOP of -6.33 mm Hg (95% CI, -8.64 to -4.01, P<.001). Aqueous depth and angle measurements improved (P<.01), whereas ECC significantly decreased (P<.001). Both corrected and uncorrected visual acuity improved (P<.01). The EQ visual analog scale did not change (P=.16), but VFQ-25 improved (P<.01). The IOP-lowering effect of PE was greater in the PACG compared to the PAC group (P=.04). In both groups, preoperative IOP was the most significant predictor of IOP change (P<.01). No sight-threatening complications were recorded. CONCLUSIONS: Our data support the usefulness of PE in lowering the IOP in patients with PAC and PACG. Although PE resulted in several anatomical and patient-reported visual improvements, we observe that a marked decrease in ECC should be carefully weighed before surgery.
Clinica Oculistica, Department of Neuroscience, Ophthalmology, Genetics, Rehabilitation, Maternal and Infantile Sciences (Di.N.O.G.M.I), University of Genova, Italy (Prof. Traverso, Dr. Cutolo), and U.O.C. Clinica Oculistica, Ospedale Policlinico San Martino, Genova, Italy (Prof. Traverso).
Classification:
9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
