Cataract extraction and intraocular pressure-lowering agents delivery: A nationwide French study between 2005 and 2017

Abstract

Purpose: Cataract and glaucoma are among the leading causes of blindness worldwide in older people, and they are often concomitant. To assess topical intraocular (IOP)-lowering agents delivery changes after cataract extraction. Material and methods: Longitudinal matched exposed–unexposed study from the French national healthcare database from January 1, 2005 to January 1, 2017. We compared individuals using topical IOP-lowering agents who underwent bilateral cataract extraction with individuals matched on IOP-lowering agents load, age, and sex who did not undergo cataract extraction. IOP-lowering agents number of drops was assessed 12 months before the first cataract extraction and compared with number of drops 12 months after the second cataract extraction. Results: About 1194 individuals treated with IOP-lowering agents were included, 597 exposed to bilateral cataract extraction and 597 unexposed to any surgery (total mean age 74.8 ± 8.3 years; 69.0% women). Mean IOP-lowering agents delivery at baseline was 1.4 daily drops in both groups. The mean number of drops decreased greater in the exposed than unexposed group (−25.5% vs −3.5%; p < 0.0001). Overall, 159 (26.6%) and 48 (8.0%) individuals in the exposed and unexposed groups interrupted medication ( p < 0.0001). Conclusions: A decrease of around one quarter of IOP-lowering agents delivery was observed after cataract extraction in the present real-life study with a longstanding interruption observed in one quarter of patients. Phacoemulsification as a standalone procedure reduces IOP-lowering agents delivery in ocular hypertension and glaucoma.

Dementia and glaucoma: Results from a Nationwide French Study between 2006 and 2018

“…To quantify the cumulative load for each individual, the number of IOP‐lowering drops dispensed was multiplied by the number of theoretical days of use for this dispensation (Drug Daily Dose [DDD] defined by the WHO) weighted by the IOP‐lowering strength of the IOP‐lowering drops (or association of eyedrops) (Table S2) (Chamard et al., 2021; Cheng et al., 2012; Higginbotham, 2010; van der Valk et al., 2005; Webers et al., 2010; WHO, 2020). For each individual, we summed the weighted DDD dispensed over the exposure period to obtain the 5‐year weighted cumulative DDD (wcDDD).…”