Diurnal Curve after Phacoemulsification in Patients with Pseudoexfoliation Syndrome and Cataract

Rao, Aparna

doi:10.3109/08820538.2011.626356

Cited by 15 publications

(11 citation statements)

References 25 publications

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“…We had an average of 3.5 mm Hg reduction in mean diurnal IOP variation at 6 month post cataract surgery which is comparable to a report by Rao A. 21 In this study, diurnal IOP variation, as well as minimum, peak, and mean IOP were significantly less two months after cataract surgery in PEX irrespective of preoperative anterior chamber depth. Therefore, we can postulate that crystalline lens in PEX syndrome may be one of the sources of IOP rise and fluctuation with some mechanisms other than changes in angle width.…”

Section: Discussionsupporting

confidence: 89%

Pseudoexfoliation syndrome: Effect of phacoemulsification on intraocular pressure and its diurnal variation

Vahedian

Salmanroghani

Fakhraie

et al. 2015

Journal of Current Ophthalmology

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PurposeTo evaluate the effect of phacoemulsification on intraocular pressure (IOP) in pseudoexfoliation (PEX) syndrome and its diurnal variation.MethodsIn this prospective, non-comparative, interventional case series, phacoemulsification was done for patients with PEX and concomitant visually significant cataract. Follow-up examinations including IOP measurement were done at postoperative day 1, week 1, month 1, month 3, and month 6. All IOP measurements were performed twice daily: once in the morning between 8 and 10 AM and the other in the evening between 6 and 8 PM. The minimum and maximum IOP and the mean IOP were recorded. IOP variation was defined as the difference between maximum and minimum pressures.ResultsSixty-eight eyes of 68 patients were analyzed. The mean IOP dropped from 17.45 ± 3.32 mm Hg to 12.57 ± 1.58 mm Hg at 6 months. The minimum and maximum IOP dropped from 14.97 ± 3.46 mm Hg and 20.03 ± 3.39 to 11.53 ± 1.79 mm Hg and 13.01 ± 1.81 after 6 months, respectively. Diurnal IOP variation dropped from 5.06 ± 1.85 mm Hg (range 2–10) at baseline to 1.49 ± 0.93 mm Hg (range 0–4) at postoperative month 6 (p < 0.001 for all). This drop was not correlated with age and CCT, but was strongly correlated with baseline IOP variation (r = 0.847, p < 0.001).ConclusionPhacoemulsification without any additional intervention can be an attractive choice in managing the IOP and its diurnal variations in pseudoexfoliation patients, even with elevated IOP, who do not have advanced optic nerve damage.

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Section: Discussionsupporting

confidence: 89%

Pseudoexfoliation syndrome: Effect of phacoemulsification on intraocular pressure and its diurnal variation

Vahedian

Salmanroghani

Fakhraie

et al. 2015

Journal of Current Ophthalmology

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“… [4] , [7] From a clinical perspective, early lens removal in the earlier stages may theoretically prevent further progression of the disease. [22] Some of the eyes with classical form showed a wave like pattern of deposits anterior to the curled up classical exfoliation membrane with globular deposits atop a stalk, indicating that these deposits were washed off in a wave form resultant to iris movement (or rather pupillary movement under physiologic conditions) over the lens. The globular deposits at the “bank” would therefore represent deposits which were washed to the “shore” (periphery to centre) by iris movement.…”

Section: Discussionmentioning

confidence: 99%

Pattern of Pseudoexfoliation Deposits on the Lens and Their Clinical Correlation- Clinical Study and Review of Literature

Rao

Padhy

2014

PLoS ONE

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PurposeTo study the clinical correlates of pattern of deposits over the lens in patients with pseudoexfoliation syndrome (PXF) or pseudoexfoliation glaucoma.MethodsThis retrospective observational study screened 346 patients with PXF seen in glaucoma clinic of a tertiary hospital from 2011–2013. Details like pattern of deposits, location on the lens surface and pupillary abnormalities in slit lamp photographs and their correlation with clinical and demographic variables, were analysed.ResultsA total of 84 eyes of 42 patients with bilateral PXF were included for the study. Glaucoma was seen in 30 eyes with baseline IOP of 24+3.8 mm Hg. Comparing the type of deposits, namely classical (n = 39 eyes), radial pigmentary (RP) form (n = 39 eyes) and combined classical and radial pigmentary (CR) forms (n = 6 eyes) of deposits, pupillary ruff atrophy was common in all forms while poor dilatation was rare in the RP type (n = 5 vs n = 25 in classical forms, p<0.001). Mean deviation (MD) was worse in the classical and CR form as compared to RP type with the latter presenting much earlier, 43±3.2 years vs 48±4.1 years in CR and 56±5.7 years in classical form, p<0.001. The baseline IOP in the RP group (18±2.3 mm Hg) was significantly lower than the other two forms (CR 20±3.2 mm Hg, classical 28±2.3 mm Hg), p<0.001, with only 2 eyes on anti-glaucoma drugs at presentation.ConclusionPattern of exfoliation deposits may indicate the stage and severity of the disease process in evolution with the RP representing an earlier/less severe form of pseudoexfoliation syndrome.

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“…[78910111213] Recent studies also demonstrated that phacoemulsification decreased diurnal IOP fluctuations in patients with pseudoexfoliation syndrome with open or occludable angles and decreased nocturnal IOP fluctuation in patients with primary angle closure. [2223] However, such IOP reductions may not always occur after phacoemulsification, and cataract surgery may even raise IOP postoperatively. [824] In the present study, we found that IOP was reduced (from 13.8 ± 1.9 mmHg to 12.6 ± 2.1 mmHg) after phacoemulsification when measured by GAT in the sitting position ( P = 0.007).…”

Section: Discussionmentioning

confidence: 99%

Effect of cataract surgery on intraocular pressure in supine and lateral decubitus body postures

Park

Yoo

Song

et al. 2016

Indian J Ophthalmol

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Purpose:To investigate the effect of phacoemulsification on intraocular pressure (IOP) in different recumbent body postures including supine and lateral decubitus (LD) positions.Materials and Methods:This prospective, observational study included patients who had no glaucoma and who had planned to undergo phacoemulsification and intraocular lens implantation in one eye. Before and 1 month after cataract surgery, IOP was measured in both eyes using the Tono-Pen AVIA. We measured IOP in the sitting, supine, and LD (with the operated eye placed on the lower side) positions. IOP was measured 10 min after assuming each position in a randomized sequence. The Wilcoxon signed-rank test was used to compare the IOP changes before and 1 month after phacoemulsification in all postures.Results:Twenty-nine patients participated in this study. Postoperative IOP was lower than the preoperative IOP when measured by Goldmann applanation tonometry in the sitting position (13.8 ± 1.9 mmHg vs. 12.6 ± 2.1 mmHg, P = 0.007). The postoperative IOP was lower than the preoperative IOP for the supine and LD positions. The average IOP reduction of the operated eye was 0.6 mmHg, 1.7 mmHg, and 3.0 mmHg in the sitting, supine, and LD positions, respectively (sitting vs. supine, P = 0.048; sitting vs. LD, P = 0.001; supine vs. LD, P = 0.028). In the nonoperated eye, IOP did not change significantly after surgery (all P > 0.05).Conclusions:Cataract surgery lowered IOP in the sitting position as well as in the supine and LD positions. Such postoperative IOP reductions were greater in the recumbent positions than in the sitting position.

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Diurnal Curve after Phacoemulsification in Patients with Pseudoexfoliation Syndrome and Cataract

Abstract: Early cataract extraction with IOL can smooth out intraocular pressure fluctuations in patients with pseudoexfoliation and associated cataract with open or narrow angles.

Cited by 15 publications

References 25 publications

Pseudoexfoliation syndrome: Effect of phacoemulsification on intraocular pressure and its diurnal variation

Pseudoexfoliation syndrome: Effect of phacoemulsification on intraocular pressure and its diurnal variation

Pattern of Pseudoexfoliation Deposits on the Lens and Their Clinical Correlation- Clinical Study and Review of Literature

Effect of cataract surgery on intraocular pressure in supine and lateral decubitus body postures

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