Effect of Preoperative Factor on Intraocular Pressure after Phacoemulsification in Primary Open- angle Glaucoma and Primary Angle-closure Glaucoma
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Purpose: To compare the effects of cataract surgery on intraocular pressure (IOP) according to preoperativefactor in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Methods: The medical records of 75 POAG and 95 PACG patients who underwent cataract surgery were reviewed. We classified POAG patients with a preoperative peak IOP of less than 31 mmHg and less than threemedications used before surgery and PACG patients with a peak IOP of less than 42 mmHg, less than threemedications used, and peripheral anterior synechiae of less than four clock hours into group 1. Patients withlevels exceeding these thresholds were classified into group 2. The IOP, numbers of medications, and successrates were compared between two groups. Results: At 36 months after surgery, IOP reduction in group 1 was significantly greater than that in group 2among POAG patients (-1.7 ± 2.1 vs. -0.6 ± 2.0 mmHg, p = 0.021); however, there was no significant differencebetween the two groups for PACG patients (-2.5 ± 2.0 vs. -2.2 ± 3.3 mmHg, p = 0.755). The medication changeswere similar between the two groups for both POAG and PACG patients. The success rate at 36 monthswas significantly higher in group 1 than in group 2 for POAG patients (66.7% vs. 35.7%, p = 0.009), but therewas no significant difference between the two groups for PACG patients (79.1% vs. 69.2%, p = 0.264). Conclusions: For patients with relatively low peak IOP who used fewer medications before surgery, cataractsurgery alone was effective for IOP control in both POAG and PACG patients. Conversely, For POAG patientswith a history of higher peak IOP and who used more medications, cataract surgery was not effective in loweringIOP, whereas it resulted in relatively good IOP values in PACG patients.
Abstract
Purpose: To compare the effects of cataract surgery on intraocular pressure (IOP) according to preoperativefactor in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Methods: The medical records of 75 POAG and 95 PACG patients who underwent cataract surgery were reviewed. We classified POAG patients with a preoperative peak IOP of less than 31 mmHg and less than threemedications used before surgery and PACG patients with a peak IOP of less than 42 mmHg, less than threemedications used, and peripheral anterior synechiae of less than four clock hours into group 1. Patients withlevels exceeding these thresholds were classified into group 2. The IOP, numbers of medications, and successrates were compared between two groups. Results: At 36 months after surgery, IOP reduction in group 1 was significantly greater than that in group 2among POAG patients (-1.7 ± 2.1 vs. -0.6 ± 2.0 mmHg, p = 0.021); however, there was no significant differencebetween the two groups for PACG patients (-2.5 ± 2.0 vs. -2.2 ± 3.3 mmHg, p = 0.755). The medication changeswere similar between the two groups for both POAG and PACG patients. The success rate at 36 monthswas significantly higher in group 1 than in group 2 for POAG patients (66.7% vs. 35.7%, p = 0.009), but therewas no significant difference between the two groups for PACG patients (79.1% vs. 69.2%, p = 0.264). Conclusions: For patients with relatively low peak IOP who used fewer medications before surgery, cataractsurgery alone was effective for IOP control in both POAG and PACG patients. Conversely, For POAG patientswith a history of higher peak IOP and who used more medications, cataract surgery was not effective in loweringIOP, whereas it resulted in relatively good IOP values in PACG patients.
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