Clear corneal phaco lowered IOP in long-term study

Clear corneal phacoemulsification induces a small but significant reduction in IOP that is sustained up to 5 years postop, a retrospective study found.

"This study does not imply that cataract removal by phacoemulsification is a substitute for a combined procedure, but [it] may be an appropriate procedure for certain patients based on medication requirements and extent of optic nerve damage," the study authors said.

Bradford J. Shingleton, MD, and colleagues at Ophthalmic Consultants of Boston evaluated long-term changes in IOP after clear corneal phacoemulsification in 55 eyes of 48 patients with open-angle glaucoma, 44 eyes of 41 patients with suspected glaucoma and a control group of 59 eyes of 59 patients with no glaucoma. All patients had at least 3 years of follow-up.

At 3 years, mean IOP had decreased by 1.4 mm Hg (P = .0025) among patients with glaucoma, by 1.4 mm Hg (P = .004) among glaucoma suspects and by 1.7 mm Hg (P = .0005) among the normal control patients, according to the study authors.

Most patients achieved IOPs equal to their preoperative IOP or lower without increasing the number of glaucoma medications used, including 85% of glaucoma patients, 81% of glaucoma suspects and 90% of controls, the authors noted.

At final follow-up, IOP remained significantly lower in all groups. At a mean 5 years postop, IOP had decreased by an average of 1.8 mm Hg (P = .005) for glaucoma patients, by 1.3 mm Hg (P = .025) for glaucoma suspects and by 1.5 mm Hg (P < .0001) for control patients. In addition, 76% of glaucoma patients, 79% of glaucoma suspects and 85% of controls maintained IOPs less than or equal to their baseline IOP without increasing the number of glaucoma medications being used, the authors noted.

The study is published in the December issue of the Journal of Glaucoma.