Long-term changes in intraocular pressure after clear corneal phacoemulsification: Normal patients versus glaucoma suspect and glaucoma patients

Shingleton, Bradford J.; Gamell, Lisa; O’Donoghue, Mark; Baylus, Susan L; King, Randy J

doi:10.1016/s0886-3350(99)00107-8

Cited by 242 publications

(162 citation statements)

References 11 publications

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“…Many previous studies including ours 22 showed that CS lowers the IOP for several years; [23][24][25] this is consistent with the results obtained in this study. However, IOP in no eyes that underwent surgery was low enough to cause hypotension maculopathy, and was thus considered to be unrelated to the progression of ERM.…”

Section: Discussionsupporting

confidence: 92%

Influence of phacoemulsification surgery on progression of idiopathic epiretinal membrane

Hayashi

2008

Eye

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Purpose To examine whether or not phacoemulsification surgery accelerates the progression of idiopathic epiretinal membrane (ERM) by measuring the degree of ERM. Methods Forty-three consecutive eyes with idiopathic ERM that underwent phacoemulsification surgery were recruited; 41 consecutive eyes with ERM that did not undergo surgery served as controls. Foveal thickness and macular volume were measured using optical coherence tomography at 3 days after surgery (baseline), and at 3, 6, and 12 months after baseline. Visual acuity and the incidence of eyes that underwent ERM peeling surgery were also examined. Results There were no significant differences in the foveal thickness and macular volume between the two groups at baseline. The foveal thickness gradually increased by 7.0% in the cataract surgery (CS) group by 5.3% in the no surgery group at 12 months after surgery. When comparing the groups, no significant differences were found in the foveal thickness, macular volume, or their percentage increases from baseline throughout the 12-month followup period. Only one eye in the CS group underwent ERM peeling surgery within the 12 months. Mean visual acuity did not worsen significantly in either group during follow-up. Conclusion Progression of idiopathic ERM is not accelerated by phacoemulsification surgery.

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Section: Discussionsupporting

confidence: 92%

Influence of phacoemulsification surgery on progression of idiopathic epiretinal membrane

Hayashi

2008

Eye

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“…The drop in IOP observed after 1 month following cataract surgery was in agreement with previous investigations in which IOP has been reported to decrease post-operatively in the mid-to long-term. [1][2][3][4] A post-operative reduction in systemic blood pressure also occurred, however, patients are generally anxious on the day of their operation and more relaxed postoperatively that may have accounted for the observed change. The reduction in IOP and parallel reduction in systemic blood pressure in the cataract group postoperatively meant that OPP remained stable between visits.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] This outcome, which has been attributed to a widening of the anterior chamber angle, [5][6][7][8] has positive implications for glaucomatous eyes resulting in a reduced requirement for IOP-lowering medication in at least one study. 4 Hopkins 9 carried out a pilot study investigating ocular haemodynamics in a small group of cataractous eyes and reported a 20-30% decrease in pulsatile ocular blood flow (POBF) compared to normal healthy volunteers.…”

Section: Introductionmentioning

confidence: 99%

Beneficial effects of small-incision cataract surgery in patients demonstrating reduced ocular blood flow characteristics

Hilton

Hosking

Gherghel

et al. 2004

Eye

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Purpose To investigate intraocular pressure (IOP) and ocular haemodynamics following small incision cataract surgery. Methods Systemic and ocular haemodynamics, and IOP, were measured pre-operatively and 1 month post-operatively, in 25 eyes of 25 patients (mean age 72.677.9 years) scheduled for small incision cataract surgery and intraocular lens implantation; these values were compared to an untreated age-matched healthy group (n ¼ 25, mean age 72.375

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“…[73][74][75][76][77] The IOP reduction of combined phaco and ELT (phaco-ELT) is greater than that of either cataract surgery or ELT alone. 65,72 One likely explanation is the deepening of the anterior chamber angle by extraction of the thickened cataractous lens.…”

Section: Excimer Laser Trabeculotomymentioning

confidence: 99%

Endoscopic Goniotomy

Töteberg‐Harms¹,

Ciechanowski²,

Funk³

2012

US Ophthalmic Review

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Glaucoma is a leading cause of preventable and irreversible blindness. [1][2][3][4][5] Glaucoma is a chronic and progressive neurodegenerative disorder causing loss of retinal ganglion cells and their axons. 6 Characteristic 'cupping' of the optic disc is seen with corresponding loss of visual field. Elevated intraocular pressure (IOP) is a causative risk factor for the development and progression of glaucoma, and lowering IOP is the mainstay of treatment. Besides IOP, other risk factors are well-known, e.g. age, family history, and race (e.g. African descent). 7 The balance of aqueous humor production (inflow) and drainage (outflow) determines the IOP. The pathophysiology of elevated IOP in primary open-angle glaucoma (POAG) is dysfunctional drainage, specifically through the trabecular meshwork (TM). 8,9 The exact mechanisms that control drainage through the TM are not fully understood, but changes in the extracellular matrix (ECM) are one of the reasons. Furthermore, pathological accumulations of certain ECM structures within the TM have been described as causative in eyes with POAG.In managing glaucoma patients, lowering the IOP is the only available treatment with a significant body of supporting evidence. [10][11][12][13][14][15][16][17][18][19][20] Medical reduction of IOP is the first line of therapy in most cases. 12,21,20 If medical treatment fails, there are several well-established surgical procedures to reduce IOP. Trabeculectomy (TE) as it is performed today was introduced in 1968 byCairns 23 and at the same time by Linner. 24 It is still the gold standard in glaucoma surgery. The aqueous flows via a scleral flap from the anterior chamber into the subconjunctival space. 25 TE is very effective in long-term IOP reduction. 26,27 The use of antimetabolites during surgery provides an even better long-term success. [28][29][30][31][32][33][34] The greatest outflow resistance is at the location of the juxtacanalicular TM (JCT) and inner wall of Schlemm's canal. Schlemm's canal communicates with the episcleral veins. The drainage of aqueous outflow through the TM into Schlemm's canal and later on into the episcleral veins is called the trabecular outflow (83-96 %, 'conventional' pathway), the remaining 5-15 % of the aqueous humor is drained via the uveoscleral pathway ('alternative' pathway). 35,36 The JCT region, which includes the inner wall of Schlemm's canal and the underlying TM, is thought to be the region where regulation of aqueous humor outflow takes place. [37][38][39] The JCT region has the highest resistance to outflow, especially under conditions of elevated IOP. [39][40][41][42] Although TE remains the mainstay of surgical glaucoma treatment, it remains feasible to enhance aqueous outflow through the conventional pathway. Several surgical approaches have been tried, e.g. ab interno TE with the Trabectome™, 43,44 goniotomy, and goniopuncture, which can be performed with or without endoscopy. This paper focuses on another technique, excimer laser trabeculotomy (ELT, also known as excimer laser...

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Long-term changes in intraocular pressure after clear corneal phacoemulsification: Normal patients versus glaucoma suspect and glaucoma patients

Abstract: Clear corneal phacoemulsification was associated with a statistically significant long-term reduction in IOP.

Cited by 242 publications

References 11 publications

Influence of phacoemulsification surgery on progression of idiopathic epiretinal membrane

Influence of phacoemulsification surgery on progression of idiopathic epiretinal membrane

Beneficial effects of small-incision cataract surgery in patients demonstrating reduced ocular blood flow characteristics

Endoscopic Goniotomy

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