Cataract surgery alone cannot be considered an IOP-lowering procedure for open-angle glaucoma patients: an evidence-based perspective

Prata, Tiago S.; Ushida, Michele; Dorairaj, Syril

doi:10.5935/0004-2749.20150072

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…In rigorous studies, the mean long-term changes in IOP value ranged from 1.5 and 2 mmHg. However, whether this percentage reduction in IOP is clinically meaningful remains unclear (21) , also considering that no statistically significant reduction in the number of eye drops was found.…”

Section: Discussionmentioning

confidence: 97%

Complicated trabeculectomy converted into ab externo cyclodialysis

Ibrahim¹,

Pereira²,

Terenzi³

et al. 2024

ABO

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The purpose of this study was to investigate the postoperative outcomes and evaluate the success predictors of phacoemulsification with Kahook Dual Blade goniotomy for cataract and glaucoma management in eyes with primary open-angle glaucoma.Methods: This was a retrospective, non-comparative; interventional case series in which all patients with primary open-angle glaucoma who underwent phacoemulsification with Kahook Dual Blade goniotomy between June 2018 and April 2019 were enrolled. All the participants had a minimum follow-up period of 6 months. Preoperative and postoperative intraocular pressure values (at 1, 3, and 6 months), number of antiglaucoma medications, best-corrected visual acuity, surgical complications, and any subsequent related events or procedures were recorded. A logistic regression analysis was performed to investigate the association between the different variables and surgical outcomes.Results: A total of 47 patients (57 eyes) were included (mean age, 70.5 ± 7 years). The mean intraocular pressure was reduced from 15.5 ± 4.2 mmHg to 12.2 ± 2.4 mmHg at the last follow-up visit (p<0.001). The mean number of antiglaucoma medications decreased significantly from 1.9 ± 1.0 to 0.6 ± 1.0 during the same period (p<0.001). On the basis of the predefined criterion (intraocular pressure reduction ≥20% and/or reduction ≥1 medication), the 6-month success rate was 86%. A higher preoperative intraocular pressure value (odds ratio [OR]= 2.01; p=0.016) and greater percentage of initial (30 days) intraocular pressure reduction (OR= 1.02; p=0.033) were sig nificantly associated with surgical success. Conclusion: Our findings suggest that phacoemulsification with Kahook Dual Blade goniotomy is an effective and safe alternative for cataract management in eyes with primary open-angle glaucoma that positively impacts intraocular pressure control and medication burden. Eyes with higher baseline intraocular pressure and a more pronounced initial response to the procedure appeared to present better outcomes at 6 months. Further studies are needed to evaluate the long-term efficacy and safety profile of the procedure.

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Section: Discussionmentioning

confidence: 97%

Complicated trabeculectomy converted into ab externo cyclodialysis

Ibrahim¹,

Pereira²,

Terenzi³

et al. 2024

ABO

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“…Prata et al . [ 22 ] showed that 40% of glaucoma patients lost IOP control during the first year after cataract surgery. Similar results were demonstrated by Shingleton et al .…”

Section: Discussionmentioning

confidence: 99%

Comparative study of surgical outcomes of twin-site phacotrabeculectomy with mitomycin C in primary open-angle glaucoma versus primary angle-closure glaucoma

Maheshwari,

Pillai,

Kanduri

et al. 2023

Indian Journal of Ophthalmology

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Purpose: To compare the surgical outcomes of twin-site phacotrabeculectomy with Mitomycin C (MMC) in primary open-angle glaucoma (POAG) versus primary angle-closure glaucoma (PACG). Methods: Prospective, comparative, observational study. Patients with visually significant cataract and primary glaucoma were divided into two groups: POAG and PACG. They underwent twin-site phacotrabeculectomy with MMC and followed up on days 1, 15, 1 month, 6 months, and 12 months. Baseline and follow-up visits were compared to find the differences in intraocular pressure (IOP), antiglaucoma medications (AGM), success rates, anterior chamber depth (ACD), and axial length (AXL). Results: There were 50 eyes each in POAG and PACG groups. Mean IOP reduction from baseline to 12 months (21.22 ± 6.0 to 11.40 ± 2.8—POAG group vs 24.16 ± 7.6 to 12.42 ± 3.2—PACG group) was statistically significant in both groups (P < 0.001), but no significant difference between groups (P = 0.095). There was a statistically significant decline in the number of AGM in POAG [1.66 (0.7) to 0.38 (0.7), P < 0.001] and PACG [2.10 (0.7) to 0.70 (0.8), P < 0.001]; the decline was more in POAG (P = 0.012) at last visit. Probability of overall (complete and qualified) success at 12 months postop was 72.0% [95% confidence interval (CI): 57.4–82.4] in PACG and 84.0% (95% CI: 70.5–91.7) in POAG group. There was a significant increase in ACD and a decrease in AXL in both groups (P < 0.001). More interventions were required in the PACG group (38, P = 0.012). Conclusion: Phacotrabeculectomy with MMC causes a significant reduction in IOP and improvement in biometric parameters in both POAG and PACG. Patients with PACG required more postoperative interventions, while a lesser number of antiglaucoma medications were needed in POAG patients.

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“…Moreover, more IOP decrease was acquired in group 2 at postoperative status. In the interim, Prata et al [22] . detailed that cataract surgery procedure could decrease IOP during the first few days after phacoemulsification procedure.…”

Section: Discussionmentioning

confidence: 99%

Anterior Chamber Configuration Changes after Phacoemulsification and Intraocular Lens Implantation Measured by Anterior Segment Optical Coherence Tomography

Ragheb

Amin

2021

International Journal of Medical Arts

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Background: Phacoemulsification can cause changes in the measurements of the anterior segment. Anterior segment optical coherence tomography [AS-OCT] is a disconnected probe device that can detect variations in the anterior segment parameters. The aim of the work: The current study aimed to investigate changes in anterior chamber angle [ACA] morphology and intraocular pressure [IOP] after phacoemulsification of cataract and intraocular lens implantation by comparing two groups of patients using two brands of IOL [Sensar 1 hydrophobic one-piece IOL] and [Eyecryl hydrophilic one-piece IOL] in patients with senile cataract using [AS-OCT]. Patients and Methods: Our study was a prospective randomized study including 30 eyes with impaired vision due to cataract, as the only cause of visual regression selected from the patients who attended Al-Azhar University Hospital [Damietta branch] Ophthalmic outpatient Clinic and were randomized into two groups. Group A [15 eyes] was implanted with [Sensar 1 hydrophobic IOL] and Group B [15 eyes] was implanted with [Eyecryl hydrophilic IOL].Results: the results revealed that there was a significant increase in the AC angle in both groups, except for the AC depth in group A, but the difference between groups was statistically non-significant. Conclusion:Phacoemulsification with IOL implantation led to an increase in the ACA, a marked increase in BCVA and a reduction in IOP, if using [Sensar 1 hydrophobic one-piece IOL] or [Eyecryl hydrophilic one-piece IOL]. However, we cannot generalize the results because of the small sample size.

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Cataract surgery alone cannot be considered an IOP-lowering procedure for open-angle glaucoma patients: an evidence-based perspective

Cited by 6 publications

References 19 publications

Complicated trabeculectomy converted into ab externo cyclodialysis

Complicated trabeculectomy converted into ab externo cyclodialysis

Comparative study of surgical outcomes of twin-site phacotrabeculectomy with mitomycin C in primary open-angle glaucoma versus primary angle-closure glaucoma

Anterior Chamber Configuration Changes after Phacoemulsification and Intraocular Lens Implantation Measured by Anterior Segment Optical Coherence Tomography

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