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Abstract #22369 Published in IGR 10-4
Effect of phacoemulsification on intraocular pressure in eyes with pseudoexfoliation: Single-surgeon series
Shingleton BJ; Laul A; Nagao K; Wolff B; O'Donoghue M; Eagan E; Flattem N; Desai-Bartoli SJournal of Cataract and Refractive Surgery 2008; 34: 1834-1841
PURPOSE: To assess the effect of phacoemulsification with posterior chamber intraocular lens (IOL) implantation performed by a single surgeon on intraocular pressure (IOP) and glaucoma medication requirements in pseudoexfoliation (PFX) eyes with or without glaucoma. SETTING: Private practice, Boston, Massachusetts, USA. METHODS: This retrospective analysis comprised 1122 eyes with PFX having uneventful phacoemulsification with IOL implantation. Of the eyes, 882 did not have glaucoma (PFX group) and 240 had glaucoma (PXG group). A comparative outcomes analysis was performed; the analysis focused on IOP and change in glaucoma medication requirements between the 2 groups. RESULTS: The mean IOP was statistically significantly reduced through 7 years postoperatively compared with preoperatively in the PFX group. The PXG group had reduced mean IOP for 1 year and reduced glaucoma medication requirements at almost all postoperative time intervals. Higher mean preoperative IOP was associated with a greater reduction in mean IOP postoperatively in both groups. Intraocular pressure spikes (> 30 mmHg) 1 day postoperatively occurred in 4% in the PFX group and 17% in the PXG group. Postoperatively, 2.7% of PFX eyes progressed to a need for glaucoma medication and 3.7% of PXG eyes progressed to a need for laser and/or glaucoma surgery. CONCLUSIONS: A long-term reduction in mean IOP occurred in PFX eyes with and without glaucoma. The IOP reduction was proportional to the preoperative IOP; higher preoperative IOP was associated with a greater reduction in IOP. Glaucoma progression in both groups was low, suggesting a protective effect of phacoemulsification on IOP in these eyes.
Dr. B.J. Shingleton, Private Practice, Boston, MA, USA. bjshingleton@eyeboston.com
