Short-term changes in intraocular pressure after phacoemulsification in glaucoma patients

Area of Science:

• Ophthalmology
• Glaucoma Research
• Cataract Surgery

Background:

• Phacoemulsification is a common cataract surgery technique.
• Elevated intraocular pressure (IOP) is a risk factor for glaucoma progression.
• Postoperative IOP spikes after cataract surgery can be concerning, especially in glaucoma patients.

Purpose of the Study:

• To assess short-term IOP changes following phacoemulsification in patients with and without primary open-angle glaucoma (POAG).
• To investigate the efficacy of oral acetazolamide in managing postoperative IOP in these patient groups.

Main Methods:

• A prospective, multicenter study involving 120 patients (60 with POAG, 60 controls) undergoing phacoemulsification.
• Patients received either oral acetazolamide (250 mg) or a placebo post-surgery.
• IOP was measured using Goldmann tonometry at multiple time points up to 24 hours postoperatively.

Main Results:

• Patients with POAG experienced significant IOP increases at all measured time points post-surgery.
• 20% of untreated POAG patients had IOP readings above 30 mm Hg.
• Acetazolamide significantly reduced postoperative IOP in POAG patients, preventing readings above 30 mm Hg.

Conclusions:

• Phacoemulsification can lead to significant short-term IOP elevations in both POAG and normal individuals.
• While transient IOP spikes are generally not dangerous in normal patients, they pose a potential risk in POAG patients.
• Systemic acetazolamide demonstrates significant IOP control and may be considered a standard management option for cataract surgery in POAG patients.