Cataract Surgery and Intraocular Pressure

Abstract

Cataract surgery is one of the most performed surgeries in the developed world. In addition to its significant impact on visual acuity, phacoemulsification has been hailed as a potential intraocular pressure (IOP)-lowering procedure. While current evidence suggests an overall significant and sustained decrease in IOP to exist after cataract surgery, the specific ocular characteristics that could help predict which patients are likely to benefit from this IOP-lowering effect remain unclear. This definition is important in glaucoma patients if this surgery is to be used in the treatment for this disease. Our review aims to summarize the literature on the subject, depicting possible mechanisms behind this IOP decrease, which type of patients are more likely to benefit from this surgery for IOP-lowering purposes and ultimately help optimizing disease management for the increasing number of patients with concomitant glaucoma and cataract.

Glaukomchirurgie

“…Neben der drucksenkenden Wirkung einer Kataraktoperation allein von 1,5-3 mm Hg beim primären Offenwinkelglaukom [9] kann eine Kataraktoperation auch bei wenig eingetrübter Linse im Vorfeld einer Trabekulektomie sinnvoll sein. Nach einer Trabekulektomie kommt es in ca.…”

Role of Lens Extraction In Glaucoma – A Review

“…21,22 Others while corroborating role of lens in etiopathogenesis of glaucoma advise caution in terms of patients who would ultimately gain. 11,17,23 However, a meta-analysis by Freidman et al in 2002 stated that convincing evidence exists for long-term control of IOP only by combined trabeculectomy and cataract operation rather than by cataract operation alone; with average IOP being 3-4mmHg lower in combined group along with need for fewer medications. 24 Advanced surgical trends of current era with enhanced imaging modalities leading to better insight, mandate a more recent update to resolve this dilemma.…”

“…Recent literature does document mild glaucoma cases, well controlled on few medications with a visually significant cataract benefit by phacoemulsification and for this subset lens extraction alone may suffice. 23 For those cases with poor control of pressure, IOP reduction after cataract surgery depends on height of pre-op values with a linear correlation irrespective of glaucomatous optic nerve changes. 5,9,15,25 Thus a decision to undertake a lens extraction alone needs to be individually tailored depending on target pressure, patient profile, adherence to medication and accessibility to medical care.…”

Effect of a punctal plug on ocular surface disease in patients using topical prostaglandin analogues: A randomized controlled trial —Response

“…There was only one trial subject with a diagnosis of primary angle‐closure glaucoma, who was pseudophakic during study enrolment and duration, and exhibited a documented open angle and absence of PAS at study entry. Throughout the short‐study duration, no subjects received any cataract surgery, which has been shown to lower IOP even in eyes with open angles . In addition, no trial participant received any type of laser therapy (peripheral iridotomy/iridoplasty, selective laser trabeculoplasty, posterior capsulotomy) during the study.…”

“…Throughout the short-study duration, no subjects received any cataract surgery, which has been shown to lower IOP even in eyes with open angles. 3 In addition, no trial participant received any type of laser therapy (peripheral iridotomy/iridoplasty, selective laser trabeculoplasty, posterior capsulotomy) during the study.…”