Vitreous loss during phacoemulsification in glaucoma patients: long-term intraocular pressure control

To assess the long-term effect of vitreous loss during phacoemulsification on intraocular pressure (IOP) control in glaucoma patients.

Birmingham and Midland Eye Centre, City Hospital, Birmingham, United Kingdom.

In this study, 26 glaucoma cases with vitreous loss during phacoemulsification were identified from operative room records. The cases were performed from January 1999 to December 2001. Minimum follow-up was 12 months. Postoperative IOP control in eyes with vitreous loss (Group 1) was assessed and compared with that in stable fellow eyes (Group 2), which served as controls. Another control group (Group 3) comprised patients with primary open-angle glaucoma who had successful phacoemulsification. Case notes of 22 patients from the same period fulfilled these criteria.

The 3 groups were comparable in age, sex, laterality, ethnicity, mean IOP, and mean number of medications preoperatively. Twelve months after surgery, 43.2% in Group 1, 23.1% in Group 2 (P<.05) and 4.5% in Group 3 had significantly worse IOP; the differences between Group 1 and Groups 2 and 3 were statistically significant (P<.05). Intraocular pressure control was significantly better in Group 3 than in Group 2 (P<.05).

Vitreous loss during cataract surgery in glaucoma patients adversely affected IOP control in the long term. Results suggest that uneventful cataract surgery in glaucoma patients improves IOP control.