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Published on: January 26, 2018
Cataract surgery in eyes with filtered primary angle closure glaucoma
Sasan Moghimi1, Golshan Latifi, Heydar Amini
1Farabi Eye Research Center, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran ; Division of Glaucoma, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA.
Journal of Ophthalmic & Vision Research
|July 5, 2013
Summary
Cataract surgery significantly lowers intraocular pressure (IOP) and medication needs in primary angle closure glaucoma (PACG) patients who have had prior filtering surgery. Higher initial IOP and shallower anterior chambers predict greater IOP reduction after surgery.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Surgical Outcomes
Background:
- Primary angle closure glaucoma (PACG) poses a significant risk for vision loss.
- Intraocular pressure (IOP) management is crucial in PACG, often requiring surgical intervention.
- Previous filtering surgery (trabeculectomy) is common in advanced PACG cases.
Purpose of the Study:
- To assess the impact of cataract surgery on IOP in PACG patients with a history of filtering surgery.
- To determine if cataract surgery can reduce medication burden in this patient group.
- To identify factors influencing IOP reduction post-cataract surgery.
Main Methods:
- A prospective interventional case series enrolled 37 PACG patients who had previously undergone trabeculectomy.
- Phacoemulsification (cataract surgery) was performed at least 12 months post-trabeculectomy.
- IOP, visual acuity, and medication use were tracked for 12 months; anterior chamber depth was measured.
Main Results:
- Mean IOP decreased significantly from 18.16 mmHg preoperatively to 15.37 mmHg at 12 months post-surgery (P<0.01).
- The average number of glaucoma medications dropped from 1.81 to 0.86 (P=0.001).
- IOP reduction correlated with higher preoperative IOP and shallower preoperative anterior chamber depth.
Conclusions:
- Cataract surgery is effective in lowering IOP and reducing medication requirements in previously filtered PACG eyes.
- The degree of IOP reduction is influenced by baseline IOP and anterior chamber dimensions.
- Phacoemulsification offers a beneficial adjunctive effect for IOP control in complex glaucoma cases.
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