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Sustained IOP lowering a main reason to perform phaco in glaucoma patients
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WAIKOLOA, Hawaii — Among the reasons to perform phacoemulsification in patients with glaucoma, sustained lowering of IOP is at the top of the list, according to a speaker.
“The IOP-lowering effect has been known for quite some time,” Kuldev Singh, MD, said at Hawaiian Eye 2013, citing literature dating back to 1996. Furthermore, the literature suggests that this pressure-lowering effect also occurs in eyes without glaucoma that undergo phacoemulsification, and the effect is even greater in eyes with exfoliation syndrome.
More recent literature affirms that phacoemulsification has a greater pressure-lowering effect in patients with higher preoperative IOPs and that the amount of IOP lowering can be predicted by preoperative IOP and anterior chamber depth.
“When it comes to angle-closure glaucoma, both acute and chronic, there’s overwhelming evidence that cataract surgery makes sense with regard to better IOP control over the long term,” Singh said.
Singh postulated that the mechanism of action could be due to a “cleaning” of the trabecular meshwork, an opening of the trabecular meshwork or possibly an inflammatory event.
Disclosure: Singh is a consultant for Alcon Laboratories, Allergan, Bausch + Lomb, Novartis, Santen, Sucampo and Transcend Medical.