2MD, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, Department of Ophthalmology, Istanbul, Türkiye DOI : 10.37844/glau.cat.2023.18.3 Purpose: To evaluate changes in intraocular pressure (IOP) after phacoemulsification with intraocular lens (IOL) implantation in medicallytreated primary open-angle glaucoma (POAG) patients with different preoperative IOP levels.
Materials and Methods: This is a retrospective, single-center study. We retrospectively reviewed the data of 89 eyes of 68 medically-treated POAG patients who underwent uneventful phacoemulsification with posterior chamber IOL implantation between January 2017 and March 2021. If surgery was bilateral, one eye was randomly selected for analysis.
Results: Final postoperative IOP was significantly lower than preoperative IOP (13.54±2.88 vs. 16.74±4.52 mmHg, p<0.001). When evaluated by preoperative IOP range, the mean postoperative change in IOP was -0.42±2.39 mmHg in the ?15 mmHg group, -3.48±3.08 mmHg in the 16-20 mmHg group, and -10.1±2.42 mmHg in the ?21 mmHg group. IOP was significantly lowered in all groups (p<0.05). IOP reduction was significantly greater in the preoperative IOP ?21 mmHg group than the ?15 mmHg and 16-20 mmHg groups, and greater in the 16-20 mmHg group than the ?15 mmHg group (p<0.016). The number of antiglaucoma medications used at postoperative 6 months (2.26±1.03), 1 year (2.29±1.04), 2 years (2.34±1.01), 3 years (2.00±0.97), and final examination (2.33±1.04) did not differ from preoperatively (2.34±1.06) (p>0.05).
Conclusion: Phacoemulsification with IOL implantation in medically treated POAG patients can lower IOP by an average of 10 mmHg in eyes with preoperative IOP ?21 mmHg, while a much smaller reduction (-0.42 mmHg) at preoperative IOP ?15 mmHg. IOP reduction is less pronounced at postoperative 3 years compared to the early postoperative period.
Keywords : Phacoemulsification, primary open-angle glaucoma, intraocular pressure, medication