Cataract extraction after deep sclerectomy and its effect on intraocular pressure control

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Cataract Surgery

Background:

• Deep Sclerectomy (DS) with Mitomycin-C (MMC) is a surgical procedure for glaucoma management.
• Cataract extraction (CE) may be required after glaucoma surgery.
• Understanding the incidence and risk factors for CE after DS is crucial for patient management.

Purpose of the Study:

• To estimate the incidence of cataract extraction (CE) following Deep Sclerectomy (DS) with Mitomycin-C (MMC).
• To identify predisposing factors for CE after DS.
• To evaluate the effect of CE on intraocular pressure (IOP) control.

Main Methods:

• Retrospective study including 179 eyes of 179 patients who underwent DS with MMC.
• Analysis of CE incidence, predisposing factors, and IOP changes over a 5-year period.
• Kaplan-Meier survival analysis was used to estimate the probability of CE.

Main Results:

• The probability of CE after DS was 0% at 1 year, 21.0% at 5 years, and 33.2% at 7 years.
• Increasing age was a significant risk factor for CE (HR 1.05, p < 0.0001).
• Mean IOP increased from 11 mmHg to 15 mmHg within 3 months post-DS and remained elevated; no significant difference in maintaining IOP < 16 mmHg was observed.

Conclusions:

• The incidence of CE after DS is low but gradually increases over time.
• Advanced age is a significant risk factor for requiring CE post-DS.
• A modest increase in IOP and glaucoma medication use was noted after CE.