title: Intra-ocular pressure fluctuation after cataract surgery in primary angle-closure glaucoma eyes medically controlled after laser iridotomy.
abstract: OBJECTIVE
  To analyse the effect of cataract surgery on diurnal intra-ocular pressure (IOP) fluctuation in primary angle-closure glaucoma (PACG) eyes.
  
  
  METHODS
  Thirty-nine eyes of 24 patients with PACG scheduled for cataract surgery were enrolled to this prospective study. A record was made which included mean IOP measurement, anterior chamber depth (ACD), anterior chamber angle (ACA), number of antiglaucomatous medications, visual field analysis (mean deviation - MD and pattern standard deviation - PSD) and responses to the Glaucoma Quality of Life-15 (GQL-15) questionnaires. The eyes were re-evaluated at 2 and 3 months of cataract surgery.
  
  
  RESULTS
  IOP fluctuation was decreased from 4.58 ± 2.07 mmHg to 2.84 ± 1.5 mmHg (p < 0.001). The decrease in mean IOP, the number of glaucoma eye drops required (p < 0.001, p = 0.012, respectively) and the increase in mean ACD, ACA grading and SITA-standard MD (p < 0.001, p < 0.001, and p = 0.01, respectively) were statistically significant. The mean GQL-15 score was also improved (p < 0.001). The change in IOP fluctuation correlated positively with the preoperative IOP fluctuation (r = 0.56 p = 0.00), the change in ACD (r = 0.703, p < 0.001) and the change in ACA (r = 0.664, p < 0.001). In multivariate analysis, preoperative IOP fluctuation and postoperative increase in ACD were significantly associated with a reduction in IOP fluctuation of an average of 1.1 mmHg per unit change (p = 0.00 and p = 0.019, respectively).
  
  
  CONCLUSIONS
  Cataract surgery in PACG provides the opportunity to address many pathologies with one intervention; improving vision, diminishing IOP, blunting IOP fluctuation, reducing need for medications, eliminating a narrow angle and improving GQL-15 scores.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey. pelingesoglu@yahoo.com.tr.
authors.forename: Pelin
authors.initials: P
authors.lastname: Özyol
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Özyol
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Sül
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Baldemir
authors.affiliation: Department of Public Health, Faculty of Cerrahpasa Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Sabanur
authors.initials: S
authors.lastname: Çavdar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000473:pathology; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D032801:Iridectomy; D007498:Iris / Q000601:surgery; D053685:Laser Therapy; D019654:Lens Implantation, Intraocular; D008297:Male; D009883:Ophthalmic Solutions; D018918:Phacoemulsification; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D011788:Quality of Life / Q000523:psychology; D014065:Tonometry, Ocular; D014794:Visual Fields
chemical_list: D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions
keywords: cataract surgery; intra-ocular pressure; intra-ocular pressure fluctuation; primary angle-closure glaucoma