Changes in ocular morphology after cataract surgery in open angle glaucoma patients

Pakulienė, Giedrė; Kuzmienė, Loreta; Siesky, Brent; Harris, Alon; Janulevičienė, Ingrida

doi:10.1038/s41598-021-91740-z

Cited by 3 publications

(3 citation statements)

References 49 publications

(49 reference statements)

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“…They also found steroid response to be associated with longer axial length regardless of glaucoma status and with more preoperative medications in glaucoma patients. However, absolute IOP reduction at 6 months postcataract surgery was found to be more pronounced in patients with OAG compared with nonglaucomatous eyes in a recent study from Pakuliene et al [46 ▪ ]. They also found that the reduction in IOP did not correlate with preoperative ACA width in either group, and that the axial length was shorter postoperatively in the control group, but remained similar in the OAG group.…”

Section: Postoperative Considerationsmentioning

confidence: 86%

Refractive surgery for the glaucoma suspect

Hein

Tauber

Shrivastava

2023

Current Opinion in Ophthalmology

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Purpose of reviewThe aim of this study was to provide an update on perioperative considerations in the evaluation and management of patients undergoing primary corneal and intraocular refractive procedures who are at risk for progressive glaucomatous optic neuropathy.Recent findingsThe necessity of a comprehensive baseline assessment prior to refractive procedures with structural and functional testing, along with documentation of preoperative intraocular pressure (IOP) measurements, is highlighted in recent literature. Substantiation of the increased risk of postoperative IOP elevation in keratorefractive procedures in patients with higher baseline IOP and lower baseline CCT, but not necessarily the degree of myopia, has been variably evidenced. Tonometry methods which are less influenced by postoperative corneal structural change should be considered in patients undergoing keratorefractive procedures. Vigilence in postoperative monitoring for progressive optic neuropathy is suggested given evidence of an increased risk of steroid-response glaucoma in these patients. Additional evidence for the IOP-lowering impact of cataract surgery in patients with an increased risk of glaucoma is provided, irrespective of intraocular lens choice.SummaryPerforming refractive procedures on patients at risk for glaucoma remains controversial. Definitive steps to optimize patient selection along with vigilance in disease state monitoring with longitudinal structural and functional testing can help mitigate potential adverse events.

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Section: Postoperative Considerationsmentioning

confidence: 86%

Refractive surgery for the glaucoma suspect

Hein

Tauber

Shrivastava

2023

Current Opinion in Ophthalmology

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“…Furthermore, Pakuliene et al identified a shortening of AL in normotensive eyes and no change in OAG eyes postoperatively. 30 The authors attributed this finding to the difference in scleral rigidity in glaucomatous eyes. In our present study, these findings coincide only with our arm of OAG eyes.…”

Section: Discussionmentioning

confidence: 99%

Impact of Cataract Surgery on IOP and Ocular Structures in Normotensive Patients and Primary and Exfoliation Open-Angle Glaucoma Patients

Xirou¹,

Xirou²,

Siganos³

et al. 2023

OPTH

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The aim of this study was to evaluate and compare the changes in Intraocular Pressure (IOP) and other ocular parameters: the Anterior Chamber Angle (ACA), Anterior Chamber Volume (ACV), and Anterior Chamber Depth (ACD) during phacoemulsification surgery in Greek patients with normotensive eyes and those with well-controlled Open-Angle Glaucoma (OAG). Additionally, parameters such as the Corneal Thickness (CCT), Axial Length (AL), Central Macular Thickness (CMT), and Retinal Nerve Fibre Layer (RNFL) were also examined. Patients and Methods: This was a prospective observational case-control study that included 50 phakic eyes, 25 normotensive (Group 1), and 25 with OAG: 15 Primary Open-Angle Glaucoma (POAG) and 10 Exfoliation Glaucoma (EXG) (Group 2). Ophthalmic assessment included IOP measurements, ocular biometry, and anterior and posterior segment optical coherence tomography evaluation of the aforementioned ocular parameters, prior and 6 months after phacoemulsification surgery. Results: At the 6 months post-operative review, a greater IOP reduction was recorded in eyes with OAG, in comparison to normotensive ones (5.3mmHg and 1.6 mmHg respectively). In addition, a significant but similar increase was recorded in the values of the ACA, ACV, and ACD of both groups between the pre-and the post-op period. Furthermore, the CCT and AL values remained unaltered. Finally, there was a non-statistically significant change in the mean CMT and the mean average RNFL of both groups. Conclusion:Eyes with OAG tend to undergo a greater reduction in IOP post-phacoemulsification surgery, in comparison to normotensive eyes. This reduction may not be solely attributed to ocular anatomical changes after phacoemulsification surgery but may also be due to the remodeling of the trabecular meshwork and the ciliary body. This may be especially true in the case of OAG eyes, which already start off with a compromised trabecular endothelium prior to surgery.

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“…[ 13 14 ] With the larger pseudophakic posterior chamber, a larger amount of aqueous humor flows from the posterior chamber to the anterior chamber with each ocular movement. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

Pseudophakic reverse pupillary block after implantation of a single-piece foldable intraocular lens in the capsular bag: Case report and literature review

Abushanab,

Solyman,

Sakr

et al. 2023

Oman Journal of Ophthalmology

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Reverse pupillary block with intraocular pressure (IOP) elevation after cataract surgery with in-the-bag implantation of intraocular lens (IOL) is considered a very rare complication. We report the case of a 47-year-old female patient with bilateral high axial myopia and posterior staphyloma presented with left acute loss of vision and eye pain, headache, and vomiting 2 weeks after uneventful presenile cataract surgery with single-piece IOL implantation in the capsular bag 1 month and 2 weeks in the right and left eyes, respectively. Gonioscopy showed extremely wide angle in all quadrants compared to the other eye with Spaeth classification of E 60c + 2 (14). Ultrasound biomicroscopy of the left eye showed epithelial corneal edema, 4.56 mm-deep anterior chamber, abnormal iris configuration with posterior concavity, and angle opening ranging between 60° and 74°, with unremarkable posterior chamber IOL and ciliary body. We managed the patient with topical antiglaucoma medications and laser peripheral iridotomy. IOP returned to normal levels. The patient was followed for 12 consecutive months. Elevated IOP from the reverse pupillary block is a rare postoperative complication of cataract surgery. It was initially described in association with the ciliary sulcus implanted IOL. Elevated IOP from the reverse pupillary block was then reported associated with scleral sutured IOLs and Yamane technique, and most recently with in-the-bag implanted 3-piece-IOL. Herein, we report the first case of pseudophakic reverse pupillary block in association with in-the-bag implanted single-piece foldable acrylic IOL.

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Changes in ocular morphology after cataract surgery in open angle glaucoma patients

Cited by 3 publications

References 49 publications

Refractive surgery for the glaucoma suspect

Refractive surgery for the glaucoma suspect

Impact of Cataract Surgery on IOP and Ocular Structures in Normotensive Patients and Primary and Exfoliation Open-Angle Glaucoma Patients

Pseudophakic reverse pupillary block after implantation of a single-piece foldable intraocular lens in the capsular bag: Case report and literature review

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