Long-term intraocular pressure control after clear corneal phacoemulsification in glaucoma patients.
OBJECTIVE
To evaluate long-term IOP control after sutureless clear corneal phacoemulsification in eyes with preoperatively controlled glaucoma.


METHODS
Institutional study.


METHODS
The charts of 345 patients who had uneventful sutureless clear corneal phacoemulsification with acrylic foldable lens (IOL) implantation were retrospectively reviewed. Included were 58 patients with medically controlled open-angle glaucoma and 287 normal controls. Follow-up was 1 to 2 years. Outcome measures were postoperative IOP and number of glaucoma medications.


RESULTS
Postoperatively, there was an insignificant decrease in IOP in the glaucoma group; the mean decrease was 1.5 mm Hg +/- 4.4 (SD) at 12 months and 1.9 +/- 4.9 mm Hg at 24 months. The mean number of medications decreased significantly at 12 months (0.53 +/- 0.86) and at 24 months (0.38 +/- 0.9) (P=.04). The control group also had a significant decrease in IOP, with a mean decrease of 0.72 +/- 3.7 mm Hg at 12 months (P=.01) and 1.33 +/- 3.2 mm Hg at 24 months (P<.0001). The decrease in IOP was more pronounced in eyes with a higher preoperative IOP in both the glaucoma and control groups.


CONCLUSIONS
These findings suggest that sutureless clear corneal phacoemulsification with foldable acrylic IOL implantation is a relatively simple and efficient surgical option in patients with cataract and well-controlled glaucoma. The approach combines long-term IOP control with fewer medications and leads to rapid visual rehabilitation.
Mathalone
Nurit
N
Department of Ophthalmology, Carmel Medical Center, Haifa, Israel.
Hyams
Michael
M
Neiman
Sarit
S
Buckman
Gila
G
Hod
Yair
Y
Geyer
Orna
O
D000180:Acrylic Resins; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications*; D003315:Cornea / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications*; D006801:Humans; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D018918:Phacoemulsification / Q000379:methods*; D012189:Retrospective Studies; D013536:Suture Techniques
D000180:Acrylic Resins