Glaucoma linked to lower visual acuity, more complications after cataract surgery

Issue: January 10, 2016

Eyes with glaucoma had a higher risk of complications and less visual improvement after cataract surgery than eyes without glaucoma, according to a large study. However, glaucoma patients still had a significant improvement in visual outcomes.

Data were culled from the Veterans Affairs Ophthalmic Surgery Outcomes Database Pilot Program, which was designed to assess and improve cataract surgery in the VA system. The study included 4,914 eyes that underwent cataract surgery: 608 eyes with glaucoma and a control group comprising 4,306 non-glaucomatous eyes.

Investigators analyzed case records of patients who underwent cataract surgery. Preoperative and postoperative scores on the National Eye Institute-Visual Function Questionnaire (NEI-VFQ) were also analyzed.

Adjusted data showed that eyes with glaucoma were significantly more likely to have posterior capsular tears with vitrectomy (P = .03) and sulcus IOL placement during cataract surgery (P = .03) than eyes without glaucoma.

Eyes with glaucoma were more likely to have postoperative inflammation (P < .0001), prolonged IOP elevation (P = .0003) and additional surgery within 30 days (P = .03).

Mean best corrected visual acuity and NEI-VFQ scores improved significantly in both groups (P < .0001). However, BCVA and NEI-VFQ scores improved significantly more in the non-glaucoma group than in the glaucoma group (P = .01 and P < .0001, respectively).

Postoperative BCVA was 20/40 or better in 94.1% of non-glaucoma cases and 89.6% of glaucoma cases; the between-group difference was significant (P = .0003). – by Matt Hasson

Disclosure: Turalba reports no relevant financial disclosures. See the full study for a list of all authors’ relevant financial disclosures.

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Source:

Turalba A, et al. Am J Ophthalmol. 2015;doi:10.1016/j.ajo.2015.07.020.