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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Related Experiment Video

Updated: Jun 24, 2025

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Predictive biomarkers of intra-ocular pressure decrease after cataract surgery associated with trabecular washout in

Rodolphe Vallée1,2,3, Enrico Meduri4, Jean-Noël Vallée5

  • 1Diagnostic and Functional Neuroradiology and Brain stimulation Department, 15-20 National Vision Hospital - Paris University Hospital Center, University of PARIS-SACLAY - UVSQ, Paris, France. vallee.sciences@gmail.com.

Scientific Reports
|June 12, 2024
PubMed
Summary

Preoperative intra-ocular pressure (IOP) is a key biomarker for predicting IOP reduction after cataract surgery with trabecular washout in pseudo-exfoliative glaucoma. Higher baseline IOPs correlate with greater IOP decrease post-surgery.

Keywords:
BiomarkerCataractGlaucomaGoniowashIrrigation cannulaPseudo exfoliation

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Innovation

Background:

  • Pseudo-exfoliative (PEX) glaucoma is a common cause of secondary glaucoma.
  • Cataract surgery with trabecular washout (Goniowash) is a potential treatment to lower intra-ocular pressure (IOP) in PEX glaucoma.
  • Identifying predictive biomarkers for surgical success is crucial for patient management.

Purpose of the Study:

  • To investigate biomarkers predicting intra-ocular pressure (IOP) decrease after cataract surgery with trabecular washout in pseudo-exfoliative (PEX) glaucoma.
  • To evaluate the efficacy of Goniowash in PEX glaucoma patients.
  • To establish predictive thresholds for successful IOP reduction.

Main Methods:

  • A single-center, prospective observational study included 54 eyes from 35 PEX glaucoma patients undergoing cataract surgery with trabecular washout.
  • Data collected included age, gender, visual acuity, IOP, endothelial cell count, and central corneal thickness over a 16-month follow-up.
  • Multivariable binomial regression models were used to analyze predictive biomarkers.

Main Results:

  • Postoperative IOP reduction was significant at 1 month and sustained throughout follow-up (p < 0.01).
  • Preoperative IOP (IOPBL) was a significant inverse predictor of IOP decrease (p < 0.001), with an AUC of 0.85 at 1 month and 0.94 at 12 months.
  • An IOPBL threshold ≥ 15 mmHg predicted significant IOP decrease with high sensitivity and specificity.

Conclusions:

  • Preoperative IOP is a reliable biomarker for predicting successful IOP reduction after cataract surgery with trabecular washout in PEX glaucoma.
  • Patients with baseline IOP ≥ 15 mmHg are likely to achieve significant and sustainable postoperative IOP decrease.
  • Goniowash is an effective procedure for IOP management in PEX glaucoma patients.