If you have cataracts and also are being treated for glaucoma, cataract surgery may reduce your need for glaucoma medications and surgery, according to a new study.
Researchers in Korea recently conducted a retrospective study of 96 people with glaucoma who underwent phacoemulsification cataract surgery with intraocular lens (IOL) implantation for the treatment of clinically significant cataracts. Forty-eight of the patients had primary open-angle glaucoma (POAG) and 48 had primary angle-closure glaucoma (PACG).
While previous studies have shown that cataract extraction with IOL implantation lowers intraocular pressure (IOP) in patients with and without glaucoma, the focus of this study was to determine which type of glaucoma patients are most likely to achieve the greatest IOP-lowering effect of cataract surgery.
The follow-up period ranged from 24 to 54 months, with a mean of 31 months.
The researchers found that cataract surgery successfully controlled the IOP of 39.6 percent of eyes with POAG and 62.5 percent of eyes with PACG. The criteria of success was attaining an IOP of 21 mm Hg or lower without medical glaucoma treatment or with fewer anti-glaucoma medications than before surgery.
Among eyes with primary open-angle glaucoma, pre-operative factors increasing the likelihood of successful IOP control after cataract surgery were a maximum IOP lower than 31 mm Hg and use of fewer than three anti-glaucoma medications.
Pre-operative factors increasing the likelihood of success among eyes with primary angle-closure glaucoma were a maximum IOP lower than 42 mm Hg, use of fewer than three anti-glaucoma medications and less than 30 percent of the drainage angle of the anterior chamber of the eye being affected by iris adhesions called peripheral anterior synechiae.
The researchers concluded that modern small-incision cataract surgery using phacoemulsification and foldable IOL implantation may help control IOP in some glaucoma patients, reducing or eliminating their need for anti-glaucoma medicine and/or glaucoma surgery.
The study was published in this month’s issue of Canadian Journal of Ophthalmology.
Tags: glaucoma, intraocular pressure, IOP