Cataract surgery and intraocular pressure: perspective from the developing world
DOI:
https://doi.org/10.18203/2320-6012.ijrms20205659Keywords:
Phacoemulsification, Cataract, IOP, Axial lengthAbstract
Background: Cataract surgery has an IOP lowering effect. Aim of the study was to analyses and evaluate the effect of cataract surgery [phacoemulsification] for senile cataract on IOP.
Methods: This prospective observational study was carried out at two private specialized ophthalmology centers at India over a period of one year from Jan 2015 to Dec 2015. Cataract surgery (phacoemulsification) was performed on single eye of all the test subjects presenting to the out-patient departments with senile cataract without any comorbidity. Preoperative intraocular pressure (IOP) readings were noted and then compared to the post-operative IOP readings. All the data was collected and analyzed.
Results: Cataract surgery reduced the IOP by a mean of 1.6 mmHg. Eyes with a higher preoperative IOP had a much greater IOP reduction post cataract surgery. Patients having a shorter axial length had more IOP reduction after cataract surgery with a mean value of 2.4 mmHg, which was statistically significant with a p value of 0.02. Older patients had a greater decrease in IOP after cataract surgery and it was noted that the relationship between IOP and increasing age was statistically significant having a p value of 0.001.
Conclusions: Cataract surgery (phacoemulsification) has a significant IOP lowering effect and it is more in eyes having higher pre-operative IOP, shallower anterior chamber and those of the elderly.
References
Gollogly HE, Hodge DO, St. Sauver JL, Erie JC. Increasing incidence of cataract surgery: population-based study. J Cataract Refract Surg. 2013;39:1383-9.
Zetterstrom C, Behndig A, Kugelberg M, Montan P, Lundstrom M. J Cataract Refract Surg. 2015;41:1725-9.
Mathalone N, Hyams M, Neiman S, Buckman G, Hod Y, Geyer O. Long-term intraocular pressure control after clear corneal phacoemulsification in glaucoma patients. J Cataract Refract Surg. 2005;31(3):479-83.
Poley BJ, Lindstrom RL, Samuelson TW, Schulze Jr. Intraocular pressure reduction after phacoemulsification with intraocular lens implantation in glaucomatous and non-glaucomatous eyes: evaluation of causal relationship between the natural lens and open angle glaucoma. J Cataract Refract Surg. 2009;35:1946-55.
Hayashi K, Hayashi H, Nakao F, Hayashi F. Changes in anterior chamber angle width and depth after intraocular lens implantation in eyes with glaucoma. Ophthalmol. 2000;107:698-793.
Rosetti L, Goni F, Denis P, Bengtsson B, Martinez A, Heijl A. Focussing on glaucoma progression and clinical importance of progression rate measurement: a review. Eye. 2010;24(1):S1-7.
Pohjalainen T, Vesti E, Uusitalo RJ, Laatikainen L. Intraocular pressure after phacoemulsification and intraocular lens implantation in non-glaucomatous eyes with and without exfoliation. J Cataract Refract Surg. 2001;27:426-31.
O’Brien PD, Ho SL, Fitzpatrick P, Power W. Risk factors for a postoperative intraocular pressure hike after phacoemulsification. Can J Ophthalmol. 2007;42:51-5.
Slabaugh MA, Bojikian ND, Moore DB, Chen PP. Risk factors for acute postoperative intraocular pressure elevation after phacoemulsification in glaucoma patients. J Cataract Refract Surg. 2014;40:538-44.
Astrom S, Stenlund H, Linden C. Intraocular pressure changes over 21 years- a longitudinal age-cohort study in northern Sweden. Acta Ophthalmol. 2014;92:417-20.
Shin HC, Subrayan V, Tajunisah I. Changes in anterior chamber depth and intraocular pressure after phacoemulsification in eyes with occludable angles. J Cataract Refract Surg. 2010;36:1289-95.
Yang HS, Lee J, Choi S. Ocular biometric parameters associated with intraocular pressure reduction after cataract surgery in normal eyes. Am J Ophthalmol. 2013;156:89-94.
Huang G, Gonzalez E, Lee R, Chen YC, He M, Lin SC. Association of biometric factors with anterior chamber angle widening and intraocular pressure reduction after uneventful phacoemulsification for cataract. J Cataract Refract Surg. 2012;38:108-16.
Shrivastava A, Singh K. The effect of cataract extraction on intraocular pressure. Curr Opin Ophthalmol. 2010;21:118-22.
Matsumura M, Mizoguchi T, Kuroda S, Terauchi H, Nagata M. Intraocular pressure decrease after phacoemulsification-aspiration and intraocular lens implantation in primary open angle glaucoma eyes [in Japanese]. Nippon Ganka Gakkai Zasshi. 1996;100:885-9.
Suzuki R, Kuroki S, Fujiwara N. Ten-year follow-up of intraocular pressure after phacoemulsification and aspiration with intraocular lens implantation performed by the same surgeon. Ophthalmologica 1997;211:79-83.
Doyle L, Little JA, Saunders KJ. Repeatability of OCT lens thickness measures with age and accommodation. Optom Vis Sci. 2013;90:1396-405.
Zhou YH, Wang M, Li Y, Hao YT, Lin MK, Fang M, et al. Phacoemulsification treatment of subjects with acute primary angle closure and chronic primary angle closure glaucoma. J Glaucoma. 2009;18:646-51.
Huang G, Gonzalez E, Peng PH, Lee R, Leeungurasatien T, He M, et al. Anterior chamber depth, iridocorneal angle width and intraocular pressure changes after phacoemulsification; narrow vs open iridocorneal angle. Arch Ophthalmol. 2011;129:1283-90.
