Long-term Follow-up of Patients receiving Intraocular Pressure-lowering Medications as Cataract Surgery Candidates: A Case—control Study

Abstract

AimIn this study, we reviewed demographics and biometric characteristics among patients receiving chronic β-blockers and prostaglandins (PGs) for primary open-angle glaucoma. We compared the age at the time of cataract surgery in different patient groups and in a control group which was not under any medication.Materials and methodsRetrospective chart review of glau-comatous patients who underwent cataract extraction at the Department of Ophthalmology of the University Hospital of Heraklion, Crete, Greece, between January 1998 and December 2016 was done. Age at cataract surgery, axial length (AL), and preoperative and postoperative best-corrected visual acuities (BCVAs) were recorded. A cohort of patients without glaucoma who were operated for cataract extraction was also evaluated.ResultsIn all, 320 patients were reviewed. There were significant results in mean age difference between the beta-antagonist and the PG group [3.05 years, 95% confidence interval (CI) 1.54-4.57] and between the beta-antagonist group with the patients receiving a combined therapy (3.02 years, 95% CI 1.14-4.91). No significant difference was found between the PG and the combination group. All the three treated groups had a significant lower mean age than the control group at the time of cataract surgery.ConclusionBased on our study, we concluded that there might be a possible association between chronic treatment with beta-antagonist agents and earlier cataract surgical time in the treated eye.Clinical significanceIntraocular pressure control is often usually achieved using ophthalmic agents. Their topical and systemic effects should be monitored precisely. Earlier cataract formation might be an important side effect which the physician has to keep in mind before choosing the suitable medication.How to cite this article: Bontzos G, Agiorgiotakis M, Detorakis ET. Long-term Follow-up of Patients receiving Intraocular Pressure-lowering Medications as Cataract Surgery Candidates: A Case-control Study. J Curr Glaucoma Pract 2017;11(3):107-112.

Causal Associations of Glaucoma and Age-Related Macular Degeneration with Cataract: A Bidirectional Two-Sample Mendelian Randomisation Study

“…In addition, laser treatment and trabeculectomy or minimally invasive glaucoma surgery can accelerate cataract formation. Despite a previous report indicating no difference in lens autofluorescence in patients with glaucoma or ocular hypertension (n = 22) compared with the control group (n = 24) [65], we believe that these results are inconsistent with the results of a recent study [64], as well as our study. In addition, glaucoma eye drops, such as fixed combinations, are more commonly used today than 28 years ago; thus, we believe this difference exists.…”

“…Next, regarding environmental factors, because the MR principle is an extension of the traditional causality verification method, it is possible to assume the existence of other variables. Patients with glaucoma typically use topical anti-glaucoma medications, such as miotic or β-blockers and prostaglandin analogues, which may cause earlier cataract formation [64]. In addition, laser treatment and trabeculectomy or minimally invasive glaucoma surgery can accelerate cataract formation.…”

Refractive Lensectomy and Microinvasive Glaucoma Surgery (MIGS): An Initial Approach in Glaucoma Patients over 50 Years of Age

“…If patients with mild glaucoma are less likely to adhere to topical medication treatment, the susceptibility to disease progression increases. Topical medications have also been shown to increase the risk of cataract formation [24]. Despite the initial lowering of intraocular pressure, patients with this side effect can have worsening enlargement of the lens with increased pigment liberation from iridolenticular rubbing or narrowing of the angle, potentially worsening trabecular meshwork outflow.…”

Distinguishing Glaucoma, Cataract, and Glaucoma Suspect Based on Visual Symptoms

“…However, ocular conditions may co-exist, often challenging physicians to describe to patients what condition(s) is/are most affecting their quality of life and to make appropriate clinical decisions. In glaucoma patients, comorbid cataract is particularly common as glaucoma treatments, including topical agents 11 and surgery, [12][13][14] accelerate cataract formation. 15 The decision to undergo combined cataract and glaucoma surgery versus glaucoma or cataract surgery alone is complex, 16 and may be informed by an understanding of the disease-specific symptoms affecting each patient.…”