title: Effect of phacoemulsification on intraocular pressure in eyes with pseudoexfoliation: single-surgeon series.
abstract: OBJECTIVE
  To assess the effect of phacoemulsification with posterior chamber intraocular lens (IOL) implantation performed by a single surgeon on intraocular pressure (IOP) and glaucoma medication requirements in pseudoexfoliation (PFX) eyes with or without glaucoma.
  
  
  METHODS
  Private practice, Boston, Massachusetts, USA.
  
  
  METHODS
  This retrospective analysis comprised 1122 eyes with PFX having uneventful phacoemulsification with IOL implantation. Of the eyes, 882 did not have glaucoma (PFX group) and 240 had glaucoma (PXG group). A comparative outcomes analysis was performed; the analysis focused on IOP and change in glaucoma medication requirements between the 2 groups.
  
  
  RESULTS
  The mean IOP was statistically significantly reduced through 7 years postoperatively compared with preoperatively in the PFX group. The PXG group had reduced mean IOP for 1 year and reduced glaucoma medication requirements at almost all postoperative time intervals. Higher mean preoperative IOP was associated with a greater reduction in mean IOP postoperatively in both groups. Intraocular pressure spikes (> 30 mm Hg) 1 day postoperatively occurred in 4% in the PFX group and 17% in the PXG group. Postoperatively, 2.7% of PFX eyes progressed to a need for glaucoma medication and 3.7% of PXG eyes progressed to a need for laser and/or glaucoma surgery.
  
  
  CONCLUSIONS
  A long-term reduction in mean IOP occurred in PFX eyes with and without glaucoma. The IOP reduction was proportional to the preoperative IOP; higher preoperative IOP was associated with a greater reduction in IOP. Glaucoma progression in both groups was low, suggesting a protective effect of phacoemulsification on IOP in these eyes.
authors.affiliation: Private Practice, Boston, Massachusetts, USA. bjshingleton@eyeboston.com
authors.forename: Bradford J
authors.initials: BJ
authors.lastname: Shingleton
authors.forename: Anupam
authors.initials: A
authors.lastname: Laul
authors.forename: Karina
authors.initials: K
authors.lastname: Nagao
authors.forename: Brian
authors.initials: B
authors.lastname: Wolff
authors.forename: Mark
authors.initials: M
authors.lastname: O'Donoghue
authors.forename: Edward
authors.initials: E
authors.lastname: Eagan
authors.forename: Nancy
authors.initials: N
authors.lastname: Flattem
authors.forename: Sonalee
authors.initials: S
authors.lastname: Desai-Bartoli
mesh_terms: D000368:Aged; D018450:Disease Progression; D017889:Exfoliation Syndrome / Q000150:complications*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014792:Visual Acuity