Cataract surgery alone cannot be considered an IOP-lowering procedure for open-angle glaucoma patients: an evidence-based perspective

Prata, Tiago S.; Ushida, Michele; Dorairaj, Syril

doi:10.5935/0004-2749.20150072

Cited by 6 publications

(3 citation statements)

References 19 publications

(27 reference statements)

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“…In rigorous studies, the mean long-term changes in IOP value ranged from 1.5 and 2 mmHg. However, whether this percentage reduction in IOP is clinically meaningful remains unclear (21) , also considering that no statistically significant reduction in the number of eye drops was found.…”

Section: Discussionmentioning

confidence: 97%

Complicated trabeculectomy converted into ab externo cyclodialysis

Ibrahim¹,

Pereira²,

Terenzi³

et al. 2024

ABO

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The purpose of this study was to investigate the postoperative outcomes and evaluate the success predictors of phacoemulsification with Kahook Dual Blade goniotomy for cataract and glaucoma management in eyes with primary open-angle glaucoma.Methods: This was a retrospective, non-comparative; interventional case series in which all patients with primary open-angle glaucoma who underwent phacoemulsification with Kahook Dual Blade goniotomy between June 2018 and April 2019 were enrolled. All the participants had a minimum follow-up period of 6 months. Preoperative and postoperative intraocular pressure values (at 1, 3, and 6 months), number of antiglaucoma medications, best-corrected visual acuity, surgical complications, and any subsequent related events or procedures were recorded. A logistic regression analysis was performed to investigate the association between the different variables and surgical outcomes.Results: A total of 47 patients (57 eyes) were included (mean age, 70.5 ± 7 years). The mean intraocular pressure was reduced from 15.5 ± 4.2 mmHg to 12.2 ± 2.4 mmHg at the last follow-up visit (p<0.001). The mean number of antiglaucoma medications decreased significantly from 1.9 ± 1.0 to 0.6 ± 1.0 during the same period (p<0.001). On the basis of the predefined criterion (intraocular pressure reduction ≥20% and/or reduction ≥1 medication), the 6-month success rate was 86%. A higher preoperative intraocular pressure value (odds ratio [OR]= 2.01; p=0.016) and greater percentage of initial (30 days) intraocular pressure reduction (OR= 1.02; p=0.033) were sig nificantly associated with surgical success. Conclusion: Our findings suggest that phacoemulsification with Kahook Dual Blade goniotomy is an effective and safe alternative for cataract management in eyes with primary open-angle glaucoma that positively impacts intraocular pressure control and medication burden. Eyes with higher baseline intraocular pressure and a more pronounced initial response to the procedure appeared to present better outcomes at 6 months. Further studies are needed to evaluate the long-term efficacy and safety profile of the procedure.

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Section: Discussionmentioning

confidence: 97%

Complicated trabeculectomy converted into ab externo cyclodialysis

Ibrahim¹,

Pereira²,

Terenzi³

et al. 2024

ABO

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“…Moreover, more IOP decrease was acquired in group 2 at postoperative status. In the interim, Prata et al [22] . detailed that cataract surgery procedure could decrease IOP during the first few days after phacoemulsification procedure.…”

Section: Discussionmentioning

confidence: 99%

Anterior Chamber Configuration Changes after Phacoemulsification and Intraocular Lens Implantation Measured by Anterior Segment Optical Coherence Tomography

Ragheb

Amin

2021

International Journal of Medical Arts

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Background: Phacoemulsification can cause changes in the measurements of the anterior segment. Anterior segment optical coherence tomography [AS-OCT] is a disconnected probe device that can detect variations in the anterior segment parameters. The aim of the work: The current study aimed to investigate changes in anterior chamber angle [ACA] morphology and intraocular pressure [IOP] after phacoemulsification of cataract and intraocular lens implantation by comparing two groups of patients using two brands of IOL [Sensar 1 hydrophobic one-piece IOL] and [Eyecryl hydrophilic one-piece IOL] in patients with senile cataract using [AS-OCT]. Patients and Methods: Our study was a prospective randomized study including 30 eyes with impaired vision due to cataract, as the only cause of visual regression selected from the patients who attended Al-Azhar University Hospital [Damietta branch] Ophthalmic outpatient Clinic and were randomized into two groups. Group A [15 eyes] was implanted with [Sensar 1 hydrophobic IOL] and Group B [15 eyes] was implanted with [Eyecryl hydrophilic IOL].Results: the results revealed that there was a significant increase in the AC angle in both groups, except for the AC depth in group A, but the difference between groups was statistically non-significant. Conclusion:Phacoemulsification with IOL implantation led to an increase in the ACA, a marked increase in BCVA and a reduction in IOP, if using [Sensar 1 hydrophobic one-piece IOL] or [Eyecryl hydrophilic one-piece IOL]. However, we cannot generalize the results because of the small sample size.

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“…In glaucoma patients, the indication of cataract surgery differs from other patients, depending on various factors such as disease stage, preoperative IOP, number of medications, gonioscopy appearance, age and the experience and skills of the surgeon. Therefore every surgeon should recognize the influence of cataract surgery on IOP control in each type of glaucoma [27].…”

Section: Impact Of Cataract Surgery On Intraocular Pressurementioning

confidence: 99%

Combined Glaucoma and Cataract: An Overview

Jiménez-Román¹,

Prado-Larrea²,

Laneri-Pusineri³

et al. 2018

Difficulties in Cataract Surgery

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Glaucoma and cataract frequently coexist in our elderly population regardless of geographical location or ethnicity. Cataract extraction alone has demonstrated to reduce intraocular pressure in eyes either with or without glaucoma. However, this chapter focuses on how cataract surgery might be combined with different glaucoma surgical procedures, such as trabeculectomy, non-penetrating procedures and minimally invasive procedures (MIGS), as well as implantation of drainage devices like the Trabectome ® and the iStent ® , both used for trabecular flow increase; the CyPass ® implant, which acts by increasing the uveoscleral flow; the XEN ® implant that facilitates the drainage of the aqueous humor from the anterior chamber to the subconjunctival space and finally the endocyclophotocoagulation that decreases the aqueous humor production. Current surgical options will be discussed, focusing on recently reported studies, analyzing the clinical aspects that influence the choice for each surgical treatment.

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Cataract surgery alone cannot be considered an IOP-lowering procedure for open-angle glaucoma patients: an evidence-based perspective

Cited by 6 publications

References 19 publications

Complicated trabeculectomy converted into ab externo cyclodialysis

Complicated trabeculectomy converted into ab externo cyclodialysis

Anterior Chamber Configuration Changes after Phacoemulsification and Intraocular Lens Implantation Measured by Anterior Segment Optical Coherence Tomography

Combined Glaucoma and Cataract: An Overview

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