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Cataract surgery alone reduces IOP in pseudoexfoliation
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CHICAGO — Cataract surgery lowers IOP and, in some cases, “very effectively” lowers IOP in patients with pseudoexfoliation, Karim F. Damji, MD, said at Glaucoma Subspecialty Day preceding the American Academy of Ophthalmology meeting.
In a prospective study to determine IOP response to phacoemulsification in glaucoma patients with and without pseudoexfoliation, Damji and colleagues found a significant reduction in IOP in patients with pseudoexfoliation than in patients without.
Karim F. Damji
“Our approach at the moment is, [in] those patients with no glaucoma or early glaucoma, we tend to do cataract alone. If that early or moderate glaucoma and pressure is not well controlled, we will add a microinvasive glaucoma surgery,” Damji said. “If it is advanced glaucoma or if the pressure is out of control, then we will go to phacotrabeculectomy.”
If cataract surgery is not successful, the next step would be to proceed to glaucoma surgery alone, he said.
The surgical approach to patients with pseudoexfoliation is guided by open or closed angle glaucoma, stage of glaucoma, degree of IOP elevation, ocular and systematic factors, and patient and care partner preferences.
Damji urges patients to follow up postoperatively.
“Some patients will get an unpredictable pressure rise a couple years out. Patients need to be followed closely,” he said.
Disclosure: Damji has no relevant financial disclosures.