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IOP reduction seen after phaco in eyes with primary angle closure
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Cataract surgery significantly reduced IOP in eyes with iridotomies due to primary angle closure, whether or not glaucomatous optic neuropathy was present, a Taiwanese study found.
Catherine Jui-ling Liu, MD, of Taipei Veterans General Hospital, and colleagues prospectively studied 29 eyes of 29 patients with primary angle-closure glaucoma (PACG) who underwent phacoemulsification to relieve IOP. The researchers compared this group to a control group of 28 eyes of 28 primary angle closure or angle-closure suspect (PAC/S) patients who also underwent phacoemulsification. All patients had previously undergone iridotomy due to primary angle closure. The study's goal was to determine how glaucomatous optic neuropathy affects IOP reduction, and to evaluate the preoperative factors associated with IOP control in PACG.
At 3 months' follow-up, the mean IOP in the PACG group had decreased by 1.3 ± 2.3 mm Hg. The reduction was not significantly different from that achieved in the PAC/S group, according to the study.
For the PACG group, postoperative IOP was positively correlated with preoperative mean IOP (P = .001) and preoperative anterior chamber depth (P = .03). The correlation remained significant after the researchers adjusted for glaucoma medication use, according to the study.
The number of glaucoma medications was reduced to 0.83 ± 0.89 in the PACG group (P < .001) and to 0 in the PAC/S group (P < .001). For 12 eyes with PACG (41%) and all eyes with PAC/S, the patients had stopped taking medications by 3 months' follow-up, the study authors said.
Further studies with different ethnic populations and longer follow-up times are needed to determine the long-term efficacy of phacoemulsification for patients with PACG, the authors said.
The study is published in the October issue of Archives of Ophthalmology.