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

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 (IOP_BL) 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 IOP_BL 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.