This article is more than 5 years old. Information may no longer be current.
Higher preop IOP portends greater IOP lowering in glaucoma patients after cataract surgery
Click Here to Manage Email Alerts
SAN FRANCISCO — The only predictive factor that influences the rate of IOP lowering after cataract surgery alone is preoperative IOP, according to a speaker.
"Almost everybody gets a little bit of lowering of IOP, but those with the highest IOP get the most IOP lowering," Steven L. Mansberger, MD, MPH, said at Glaucoma Day preceding the American Society of Cataract and Refractive Surgery meeting here.
However, the people whose glaucomatous disease is most likely to progress are those with the highest IOP, he said.
"Those are also the ones who are going to have the most lowering in pressure," he said. "It gets a little confusing."
Using supporting data from the Ocular Hypertension Treatment Study, reported in Ophthalmology, Mansberger said about 70% of patients would have a pressure-lowering benefit from cataract extraction and 30% would not.
Mansberger suggested performing cataract surgery alone when only a 10% to 20% drop in pressure is needed and the disease is well controlled. However, he suggested performing glaucoma surgery, including microinvasive glaucoma surgery, in patients who have a high risk of glaucoma progression or want the greatest chance of avoiding medications.
"I tell patients that approximately 10% of the time I’ll need to perform a glaucoma procedure within a month after surgery," Mansberger said, so that patients are prepared for the need for further treatment if necessary.
Reference: Mansberger SL, et al. Ophthalmology. 2012;doi:10.1016/j.ophtha.2012.02.050.
Disclosure: Mansberger has commercial relationships with Allergan, Alcon, Bausch + Lomb, CDC, Glaukos, Liquidia Technologies, Merck, NIH, Santen, Sucampo and Valeant Pharmaceuticals.