Long-term intraocular pressure control after clear corneal phacoemulsification in glaucoma patients

Mathalone, Nurit; Hyams, Michael; Neiman, Sarit; Buckman, Gila; Hod, Yair; Geyer, Orna

doi:10.1016/j.jcrs.2004.06.046

Cited by 157 publications

(112 citation statements)

References 15 publications

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“…First of all, there is a presumed and previously reported improvement in IOP following phacoemulsification alone [13,14]. This study did not include any phaco alone controls.…”

Section: Resultsmentioning

confidence: 95%

A UK case series of phaco-ECP

Gouws¹,

Langsaeter²

2015

AOVS

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Aims: Cataract surgery with combined endo-cyclophotocoagulation (phaco-ECP) remains a relatively new procedure for glaucoma specialists. Problems associated with trans-scleral photocoagulation and a lack of long-term data can cause reluctance to introducing the procedure. However, published data has shown that phaco-ECP is a valuable additional treatment for patients with concomitant cataract and glaucoma being low risk, quick and cost effective. Our retrospective case study reviews the outcome of a cohort of patients treated in one UK hospital from 2009-2013.Methods: All patients undergoing combined phaco-ECP at one UK hospital between September 2009 and November 2013 were included. All glaucoma subtypes were included as was previous surgery. We reviewed electronic and paper notes. Details collated include age, gender, glaucoma subtype, preoperative intraocular pressure (IOP) and number of topical glaucoma agents. Post-operative IOP and number of agents were collected at specified time points. The main outcome measures were IOP and number of agents used. We also report intraoperative and post-operative complications and further glaucoma operations needed.Results: 328 eyes were included of 207 patients. The mean age of participants was 78.8 years [SD +-10 years, range 62-100]. The group consisted of 52% males and 48% females. The longest follow-up was 48 months. The mean follow-up was 24 months. 154 eyes were followed up for 12 months and 105 for 24 months or more. 69 eyes were followed up for less than a year. Two of these had just two follow ups (due to passing away). The remainder were patients who had recently had surgery at the time of the audit and 9 people lost to follow-up. Two patients who passed away after the first post-op visit were excluded from the results. All eyes who had measurements available at any specific timepoint were included in the data for that part of the study. Pre-operatively, patients used a mean of 1.72 agents [SD 1.07, range 0-4] and pre-operative IOP mean was 17.1 [ SD 5.3,. The one patient who had a starting pressure of 15mmHg was on maximum tolerated medical treatment and had progressing visual field changes despite this. All the patients included in the treatment were clinically considered to be requiring additional treatment to their current tolerated medical regime due to progressive glaucoma changes. 134 patients included in the study had a pre+op IOP of <21 mm Hg but were all considered uncontrolled clinically.One year post-operatively the patients used a mean of 0.77 agents [SD 0.66, and IOP mean was 13.2 [SD 3.06,. The overall reduction in IOP at 24 months was 24.0% and the overall reduction in the number of agents used at 24 months was 38.0%. This is the biggest reported UK cohort. There were no contraindications found to perform this procedure on any of our patients. Subgroup analysis of the different glaucoma subgroups will follow as well as a further case-controlled study of phaco only patients.

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“…First of all, there is a presumed and previously reported improvement in IOP following phacoemulsification alone [13,14]. This study did not include any phaco alone controls.…”

Section: Resultsmentioning

confidence: 95%

A UK case series of phaco-ECP

Gouws¹,

Langsaeter²

2015

AOVS

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“…[5][6][7][8] For eyes with POAG, this reduction is significantly more and varies from 1.8-4.5mmHg. [5][6][7][8][9] The reduction of IOP has a linear correlation with pre-operative pressures and a study by Matsumura et al documented a 5.5 mmHg decrease in eyes with high preop IOP (>21mmHg), a 2.5mmHg reduction in cases with IOP <20mmHg and 1.5mmHg for normotensive eyes over a long term follow up of 3 years. 5 In ocular hypertensive eyes, a similar trend has been observed with a 6.5mmHg reduction in eyes with pre-op IOP between 23-31mmHg, 4.8mmHg for those in the 20-22mmHg range and 2.5 mmHg for the 18-19mmHg group.…”

Section: Effect Of Cataract Surgery On Intraocular Pressure Reductionmentioning

confidence: 99%

“…[1][2][3][4] The magnitude of this intraocular pressure (IOP) drop varies from 1.5-6.5mmHg with lower range being applicable for normotensive eyes and higher for ocular hypertensive eyes. [5][6][7][8][9] For primary open angle glaucoma (POAG), IOP decrease has been documented at 13% but for primary angle closure glaucoma (PACG), it is more significant and ranges from 13-37%. 10 However despite the plethora of articles in recent literature clear cut guidelines for lens extraction have not yet emerged with appropriateness of lens extraction being still questioned.…”

Section: Introductionmentioning

confidence: 99%

Role of Lens Extraction In Glaucoma – A Review

Singh¹

2016

Delhi Journal of Ophthalmology

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“…13 Berbagai penelitian tentang penurunan tekanan intraokular pascabedah telah banyak dilakukan, salah satu alasan yang menyebabkan penurunan tekanan intraokular yaitu berkurangnya hambatan aliran humor akuos. 7 Penelitian ini menunjukkan penurunan tekanan intraokular yang lebih besar pada kelompok subjek penelitian dengan sudut bilik mata depan tertutup (19,6%) dibandingkan dengan kelompok sudut bilik mata depan terbuka (11,3%) (Tabel 2). Rentang tekanan intraokular pascabedah pada kelompok subjek dengan sudut bilik mata depan tertutup ialah 7-14,5 mmHg dan pada kelompok subjek dengan sudut bilik mata depan terbuka yaitu 6,5-17 mmHg.…”

Section: Pembahasanunclassified

“…Keadaan ini merupakan salah satu alasan yang mengakibatkan penurunan tekanan intraokular sesudah bedah katarak. 7 Peningkatan kedalaman bilik mata depan memiliki korelasi positif dengan pelebaran sudut bilik mata depan pascabedah katarak, serta kedalaman bilik mata depan memiliki korelasi positif dengan penurunan tekanan intraokular pascabedah katarak. 8,9 Hal ini menimbulkan pertanyaan apakah mungkin bedah katarak tanpa terapi apapun dapat dipergunakan sebagai strategi yang efektif untuk menurunkan tekanan intraokular pada penderita tertentu.…”

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Penurunan Tekanan Intraokular Pascabedah Katarak pada Kelompok Sudut Bilik Mata Depan Tertutup dan Terbuka

Hapsari¹,

Prahasta²,

Enus³

2013

mkb

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AbstrakPenebalan lensa kristalina pada katarak senilis mengakibatkan hambatan pada jalur aliran akuos. Pascabedah katarak terjadi peningkatan kedalaman bilik mata depan (BMD) yang memiliki korelasi positif dengan pelebaran sudut BMD serta penurunan tekanan intraokular (TIO). Tujuan penelitian untuk menganalisis perbedaan penurunan TIO pascabedah katarak pada kelompok sudut BMD tertutup dan terbuka. Penelitian ini menggunakan desain prepost test, untuk membandingkan penurunan TIO pascabedah katarak fakoemulsifikasi pada 26 mata dari 26 orang penderita, yang dibagi menjadi kelompok sudut BMD tertutup dan terbuka masing-masing berjumlah 13 mata. Tempat penelitian Rumah Sakit Mata Cicendo Bandung periode Maret-Juni 2012. Pengambilan data berdasarkan urutan datang penderita yang direncanakan operasi katarak fakoemulsifikasi. Penilaian sudut bilik mata depan prabedah dilakukan menggunakan lensa gonio Sussman 4-mirror. Tekanan intraokular pascabedah diukur saat pemantauan minggu ketiga pascabedah. Penilaian TIO pra dan pascabedah dilakukan menggunakan alat ukur tonometri aplanasi Goldmann. Analisis statistik dilakukan menggunakan uji t. Hasil menunjukkan perbedaan penurunan TIO secara bermakna lebih besar pada kelompok sudut BMD tertutup (19,6%) dibandingkan dengan kelompok sudut BMD terbuka (11,3%) dengan nilai p=0,022. Simpulan, perbedaan penurunan TIO pascabedah katarak fakoemulsifikasi lebih besar pada kelompok sudut BMD tertutup dibandingkan dengan kelompok sudut BMD terbuka. The anterior chamber angle was measured before surgery using Sussman 4-mirror goniolens. The intraocular pressure were measured before and three weeks after surgery using Goldmann aplanation tonometer. Statistical analysis was done using t test. The results indicated that IOP reduction was statistically significant greater in the angle-closure group (19.6%) compared with open-angle group (11.3%) with p=0.022. In conclusion, IOP reduction after phacoemulsification cataract surgery was greater in the angle-closure group compared with openangle group. [MKB. 2013;45(1):56-61]

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Long-term intraocular pressure control after clear corneal phacoemulsification in glaucoma patients

Cited by 157 publications

References 15 publications

A UK case series of phaco-ECP

A UK case series of phaco-ECP

Role of Lens Extraction In Glaucoma – A Review

Penurunan Tekanan Intraokular Pascabedah Katarak pada Kelompok Sudut Bilik Mata Depan Tertutup dan Terbuka

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