Change in Perimetric Global Indices Following Cataract Surgery in Patients with Glaucoma

Abstract

To study the change in perimetric global indices following cataract surgery in patients with glaucoma & Comparison of preoperative & postoperative perimetric indices. Methodology: This Prospective study was conducted in a major tertiary care hospital. Approval of Institutional Ethics Committee was taken before start of the study. 31 Eyes of 18 Patients with co-existing cataract & Primary Open Angle Glaucoma (POAG), who were well controlled & stable on medical therapy were screened for the study & recruited as per inclusion & exclusion criteria. Follow up visits were at one & three months. Appropriate statistical analysis was done.Result: Mean MD (Mean Deviation) improved significantly from -10.77 ± 9.39 dB pre-operatively to -6.52 ± 6.75 dB postoperatively at 3 months (i.e. by 4 dB)(P value < 0.0001). 39% eyes showed improvement in MD < 2dB; 26% eyes showed improvement 2dB to 4dB & 23% showed change more than 8dB at 3 months. Mean PSD (Pattern Standard Deviation) worsened post-operatively by approximately 1dB from 4.88 ± 3.82 dB pre-operatively to 5.78 ± 4.30 dB post-operatively at 3 months. Majority of eyes showed worsening less than 2dB. (84% at 1month which increased to 94% at 3months). This was statistically significant (P value <0.004 at 1month; <0.006 at 3 months) Conclusion:In POAG patients, with presence of coexisting cataract, MD is more affected than PSD. Hence, PSD is a more useful index to monitor glaucoma in these patients. Moreover, predominantly posterior subcapsular cataract doesn't affect PSD as much as it affects the MD.