Intra‐ocular pressure fluctuation after cataract surgery in primary angle‐closure glaucoma eyes medically controlled after laser iridotomy

Özyol, Pelin; Özyol, Erhan; Sül, Sabahattin; Baldemir, Ercan; Çavdar, Sabanur

doi:10.1111/aos.13023

Cited by 12 publications

(6 citation statements)

References 25 publications

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“…Very wide variations have been reported in IOP fluctuations post cataract surgery and a lot of research work has been conducted to establish relationship between the same. (19) (20) (21) (22) ( 23) (24) Our study was conducted to find out if uncomplicated phacoemulsification could be an alternative for IOP control.…”

Section: Resultsmentioning

confidence: 99%

Trends of Fatal Poisoning in Jhalawar Region of Rajasthan: A 5 - Year Retrospective Study

Ramakant Verma,

Khushpal Singh Rathore,

Bhavesh Bohra

2021

Indian Journal of Forensic Medicine & Toxicology

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Background: Rise in Intraocular Pressure (IOP) is the major contributing factor to the pathology of glaucoma. Along with cataract, it is one of the leading causes of preventable blindness all over the world. Cataract surgery can help reduce the IOP and our study helps confirm the same.Methods: Our study included 150 eyes of 150 patients undergoing cataract surgery by phacoemulsification by a single surgeon. Complete ocular examination was performed on all the patients which included uncorrected distance visual acuity (UCVA) and best corrected visual acuity (BCVA) by Snellen's chart, anterior segment by slit-lamp, IOP by Goldmann's Applanation Tonometry (AT), gonioscopy by 4 mirror gonioscope, Anterior Chamber Depth (ACD) and Axial Length (AL) by A-scan. IOP measurements were taken between 9am and 10am. Conclusion:Our study divided the patients into 3 groups based on IOP i.e., <15, 15-19, and 19-23 mmHg of IOP. All the 3 groups showed a lesser IOP post cataract surgery. There was a significant decrease in IOP when baseline was compared with post op week 1, week 4 and week 12. Therefore our study confirms that cataract surgery with PCIOL causes reduction in IOP which remains sustained for months.

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Section: Resultsmentioning

confidence: 99%

Trends of Fatal Poisoning in Jhalawar Region of Rajasthan: A 5 - Year Retrospective Study

Ramakant Verma,

Khushpal Singh Rathore,

Bhavesh Bohra

2021

Indian Journal of Forensic Medicine & Toxicology

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“…4,7,[37][38][39][40][41] Whether clear or cataracted, a thicker lens, [41][42][43][44][45][46] a more anteriorly positioned lens, or a lens with a higher vault, [46][47][48] can contribute to a shallower anterior Many studies demonstrated the benefits of phacoemulsification in the management of PACG. 16,17,[48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] Phacoemulsification results in IOP reduction comparable to that following trabeculectomy or phacotrabeculectomy with significantly fewer complications. [14][15][16][17] However, those undergoing phacotrabeculectomy can have marginally lower IOP and less dependence on IOP lowering medications than those having phacoemulsification alone, which can be beneficial in patients with advanced PACG or poor medication compliance.…”

Section: Discussionmentioning

confidence: 99%

Anterior Chamber Angle Changes in Primary Angle-closure Glaucoma Following Phacoemulsification Versus Phacotrabeculectomy: A Prospective Randomized Clinical Trial

Ghadamzadeh

Karimi

Moghaddam

et al. 2022

Journal of Glaucoma

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We used anterior segment optical coherence tomography to investigate anterior chamber angle in primary angle-closure glaucoma (PACG) eyes following phacoemulsification and phacotrabeculectomy. Angle widening was significantly greater after phacoemulsification up to 6 months after the surgery.Purpose: To compare anterior chamber angle following 2 common surgeries for PACG.Methods: One hundred ten glaucoma patients were evaluated in this single center, prospective, randomized clinical trial. Those with concomitant PACG and senile cataract and without a history of ocular surgery, trauma, or chronic miotic use were recruited. Monocular patients were also excluded. Finally, 52 eligible subjects were randomly assigned to phacoemulsification ("Phaco" group, 25 eyes) or phacotrabeculectomy ("Combined" group, 27 eyes) surgeries. A swept-source, anterior segment optical coherence tomography device (CASIA SS-1000 OCT) was used to image the anterior segment. Mask graders used the images to measure the following parameters before and 1 week, 1 month, and 6 months after surgery: angle opening distance at 500 µm, trabecular iris surface area at 500 µm, and trabecular iris angle at 500 µm.Results: There was no significant difference between study groups regarding best-corrected visual acuity, intraocular pressure (IOP), and the number of glaucoma medications in preoperative or postoperative visits (P > 0.076). Also, the measured angle parameters were not statistically significantly different between the 2 groups before surgery (P > 0.123). After surgery, all measured parameters were significantly increased in both groups (P < 0.0001). At the 6-month follow-up, nasal angle opening distance at 500 µm was 0.383 ± 0.027 vs. 0.349 ± 0.017, trabecular iris surface area at 500 µm was 0.141 ± 0.007 vs. 0.125 ± 0.005, and trabecular iris angle at 500 µm was 40.1 ± 12.9 vs. 34.6 ± 3.1 in Phaco and Combined groups, respectively (P < 0.0001 for all).Conclusions: Anterior chamber angle widening by anterior segment optical coherence tomography was observed in PACG patients following surgery and was significantly greater after phacoemulsification compared with combined phacotrabeculectomy at all time points. Similar IOP and medication burden were noted for up to 6 months as secondary outcomes. The contribution of angle changes to the IOP-lowering effect of phacoemulsification in PACG eyes needs further study.

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“…Lens extraction reduces diurnal IOP fluctuations, IOP levels and the number of anti glaucoma medication in PACG with previous laser iridotomy, the change in IOP fluctuation values correlates positively with the change in anterior chamber deep an preoperative IOP fluctuation [38]. Thus patients with narrowest angles might experience a greater benefit from cataract surgery alone depending on the proportion of the angle that has been permanently closed by peripheral anterior synechiae.…”

Section: Cataract Surgery and Angle-closure Glaucomamentioning

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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Intra‐ocular pressure fluctuation after cataract surgery in primary angle‐closure glaucoma eyes medically controlled after laser iridotomy

Abstract: Cataract surgery in PACG provides the opportunity to address many pathologies with one intervention; improving vision, diminishing IOP, blunting IOP fluctuation, reducing need for medications, eliminating a narrow angle and improving GQL-15 scores.

Cited by 12 publications

References 25 publications

Trends of Fatal Poisoning in Jhalawar Region of Rajasthan: A 5 - Year Retrospective Study

Trends of Fatal Poisoning in Jhalawar Region of Rajasthan: A 5 - Year Retrospective Study

Anterior Chamber Angle Changes in Primary Angle-closure Glaucoma Following Phacoemulsification Versus Phacotrabeculectomy: A Prospective Randomized Clinical Trial

Combined Glaucoma and Cataract: An Overview

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