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Successful IOL exchange in glaucoma patients hinges on several factors
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SAN DIEGO — With glaucoma patients at a much higher risk of early postoperative pressure spike after IOL exchange than non-glaucoma patients, physicians must be aware of how to minimize potential issues, Ike K. Ahmed, MD, FRCSC, said here.
"Although our primary objective in glaucoma patients is, of course, lowering IOP, stability of visual field and disc damage, our patients also deserve the best uncorrected and aberration-free vision as well, not only in terms of the glaucoma status, but as far as the refractive status," Dr. Ahmed, an OSN Glaucoma Board Member, said at the American Society of Cataract and Refractive Surgery meeting.
Glaucoma patients have a 60% to 80% risk of an early postoperative IOP spike, compared with 15% to 20% in non-glaucoma patients, he said. To reduce that risk, he recommended that physicians continue regular medications after surgery. In his glaucoma patients, he uses Diamox (acetazolamide, Duramed Pharmaceuticals) 250 mg as a prescription to minimize spikes, he said.
In addition, careful selection of instrumentation and technique can be helpful in the removal and exchange of lenses in glaucoma patients. Use of a viscoelastic is also key during surgery, Dr. Ahmed said.
- Disclosure: Dr. Ahmed has no direct financial interest in the products discussed in this article, nor is he a paid consultant for any companies mentioned.