Effect of cataract phacoemulsification on intraocular pressure of patients in the early stages of open-angle glaucoma

Authors

  • V.O. Melnyk Visiobud Clinic LLC https://orcid.org/0009-0001-4177-4702
  • S.I. Zaharchuk Visiobud Clinic LLC
  • B.I. Palamar Social Medicine and Public Health Department, Bogomolets National Medical University
  • O.G. Ivaschyk Visiobud Clinic LLC

DOI:

https://doi.org/10.31288/oftalmolzh20242912

Keywords:

intraocular pressure, modified tunnel trabeculopuncture, phacoemulsification, open-angle glaucoma

Abstract

Purpose: To compare the combination procedure (modified tunnel trabeculopuncture (MTTP) plus phaco with monofocal intraocular lens (IOL) implantation) in the eye with both senile cataract and either advanced or medically uncompensated open-angle glaucoma (OAG) versus phaco with IOL implantation only in the eye with early well-compensated POAG in terms of hypotensive effect and the number of topical glaucoma medications needed.

Material and Methods: Totally, 97 patients (194 eyes; age, 60 to 85 years) with bilateral OAG and senile cataract were involved in the study. Groups and time points were compared in terms of IOP and the number of topical glaucoma medications needed.

Results: For both groups, there was a significant difference (Р <0.05) between baseline and postoperative IOP values over a 6-month period. The hypotensive effect in group 1 (MTTP plus phaco) was greater than in group 2 (phaco only) (10.8 mmHg versus 4.91 mmHg, respectively). After surgery, the mean number of topical glaucoma medications needed reduced by 2.10 in group 1 and 2.19 in group 2, and these reductions were significant (Р < 0.05).

Conclusion: In the early and late postoperative periods, there were reductions in IOP and the number of topical glaucoma medications needed in patients with OAG that underwent phaco with monofocal IOL implantation, which indicates a beneficial effect of phaco on IOP dynamics in patients with glaucoma.

References

Jimenez-Roman J, Lazcano-Gomez G, Martínez-Baez K, Turati M, Gulías-Cañizo R, Hernández-Zimbrón LF, et al. Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma. Int J Ophthalmol. 2017;10(9):1374-8. https://doi.org/10.18240/ijo.2017.09.07

Kaliardas A , Chatziralli I, Katsanos A, Kitsos G. Phacoemulsification versus Phacoemulsification/Trabeculectomy for the Treatment of Primary Open-Angle Glaucoma Coexistent with Cataract: A Comparative Study. Medicina (Kaunas). 2023 Feb 27;59(3):470. https://doi.org/10.3390/medicina59030470

Pakuliene G, Kuzmiene L, Siesky B, Harris A, Januleviciene I. Changes in ocular morphology after cataract surgery in open angle glaucoma patients. Sci Rep. 2021 Jun 9;11(1):12203. https://doi.org/10.1038/s41598-021-91740-z

Armstrong JJ, Wasiuta T, Kiatos E, Malvankar-Mehta M, Hutnik CML. The Effects of Phacoemulsification on Intraocular Pressure and Topical Medication Use in Patients With Glaucoma: A Systematic Review and Meta-analysis of 3-Year Data. J Glaucoma. 2017 Jun;26(6):511-22. https://doi.org/10.1097/IJG.0000000000000643

Masis M, Mineault PJ, Phan E, Lin SC. The role of phacoemulsification in glaucoma therapy: A systematic review and meta-analysis. Surv Ophthalmol. 2018 Sep-Oct;63(5):700-10. https://doi.org/10.1016/j.survophthal.2017.08.006

Brízido M, Rodrigues PF, Almeida AC, Abegão Pinto L. Cataract surgery and IOP: a systematic review of randomised controlled trials. Graefes Arch Clin Exp Ophthalmol. 2023 May;261(5):1257-66. https://doi.org/10.1007/s00417-022-05911-3

Published

2024-05-01

How to Cite

1.
Melnyk V, Zaharchuk S, Palamar B, Ivaschyk O. Effect of cataract phacoemulsification on intraocular pressure of patients in the early stages of open-angle glaucoma. J.ophthalmol. (Ukraine) [Internet]. 2024 May 1 [cited 2024 May 29];(2):9-12. Available from: https://ua.ozhurnal.com/index.php/files/article/view/68

Issue

Section

Clinical Ophthalmology