Source: Am J Ophthalmol. 2014;157(1):26-31.
January 02, 2014
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IOP may increase after phaco in patients with medically controlled glaucoma

Source: Am J Ophthalmol. 2014;157(1):26-31.
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IOP decreased after phacoemulsification in most open-angle glaucoma patients but increased in some patients with medically controlled glaucoma, according to a study.

The retrospective case series included 157 eyes of 157 open-angle glaucoma patients who underwent phacoemulsification.

Investigators analyzed use of glaucoma medications, disease severity and treatment, and IOP at 1 year postoperatively.

Average IOP decreased significantly, from 16.3 mm Hg preoperatively to 14.5 mm Hg postoperatively (P < .001). Mean number of glaucoma medications increased slightly, from 1.85 preoperatively to 1.92 postoperatively.

IOP increased by 3 mm Hg or more in 10 eyes (6.4%) and deceased by more than 3 mm Hg in 60 eyes (38%).

Sixty eyes (38%) required increased medication or laser treatment or had higher postoperative IOP at 1 year with no change in medication.

Average preoperative IOP was less than 20 mm Hg in 20 of 21 eyes that had no change in medication after phacoemulsification but had elevated IOP after surgery.

“We confirm that in medically controlled glaucoma patients with documented open angles by gonioscopy, the preoperative IOP is the strongest predictor of postoperative IOP change,” the study authors said.

Among eyes with no postoperative medication changes, higher preoperative IOP, increased age and greater anterior chamber depth correlated with lower postoperative IOP.

Disclosure: See the study for a full list of all authors’ relevant financial disclosures.