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Long-term Intraocular Pressure Elevation after Primary Angle Closure Treated with Early Phacoemulsification.
Sung Uk Baek1, Kwang Hyun Kim2, Joo Yeon Lee2
1Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Korean Journal of Ophthalmology : KJO
|March 22, 2018
Summary
Phacoemulsification in acute primary angle closure attack eyes led to higher rates of intraocular pressure (IOP) rise and new glaucoma development compared to fellow eyes. Long-term monitoring is crucial even after successful IOP control.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Cataract Surgery Outcomes
Background:
- Acute primary angle closure (APAC) is a serious condition requiring prompt management.
- Phacoemulsification is a common surgical intervention for APAC and cataracts.
- Long-term effects of phacoemulsification on intraocular pressure (IOP) and glaucoma development in APAC eyes require further investigation.
Purpose of the Study:
- To evaluate long-term intraocular pressure (IOP) changes after phacoemulsification in eyes that experienced acute primary angle closure (APAC).
- To assess the incidence of newly developed glaucoma in APAC eyes treated with phacoemulsification.
- To compare outcomes between APAC eyes and their fellow eyes undergoing phacoemulsification.
Main Methods:
- Retrospective chart review of 89 eyes from patients with APAC.
- Comparison of APAC eyes (Group A) versus fellow eyes (Group B) that underwent phacoemulsification within one month of the APAC attack.
- Outcomes measured included IOP rise (>21 mmHg) and new glaucoma development over 12 months.
Main Results:
- A significantly higher cumulative rate of IOP rise was observed in Group A (22.58%) compared to Group B (11.11%) at 12 months (p=0.001).
- New glaucoma developed in 6 patients in Group A, while none were observed in Group B (p<0.001).
- Phacoemulsification in APAC eyes showed a higher prevalence of IOP rise and glaucoma than in fellow eyes.
Conclusions:
- Phacoemulsification in APAC eyes is associated with a greater risk of IOP elevation and subsequent glaucoma development compared to fellow eyes.
- Even with successful IOP control post-APAC and phacoemulsification, vigilance for IOP rise and glaucoma is necessary.
- These findings highlight the potential for long-term complications following phacoemulsification in the context of APAC.
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