Cataract surgery significantly lowers pressure in chronic angle-closure glaucoma patients

SAN FRANCISCO — Phacoemulsification alone reduced IOP by 23% in patients with narrow angles and chronic angle closure glaucoma who had the highest preoperative IOP, a study found.

"Cataract surgery in angle closure reduces pressure, and the reduction in pressure is proportional to the preop pressure," Reay H. Brown, MD, said at Glaucoma Day at the American Society of Cataract and Refractive Surgery meeting.

Dr. Brown presented results of a study that he conducted with colleagues, examining 83 patients who had angle closure or narrow angles. The average follow-up was 3 years. All patients underwent phaco without an additional glaucoma procedure.

In all patients, the average preop pressure was 17.5 mm Hg and the average postoperative pressure was 14.3 mm Hg, for a 19% reduction.

The 19 patients in the study who had the highest preop pressure, at more than 20 mm Hg, also had the highest reduction, at 5.2 mm Hg, Dr. Brown said. Medications for that group went from 1.2 to 0.9, he said.

Dr. Brown said it appears that cataract surgery addresses the basic physiology of the angle closure or narrow angle eye.

"In angle closure, the lens is the enemy — the eye's too short, the lens can take up too much space," he said. "We can't win in the eye, but we can create space by removing the lens, as we've done in these patients."