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Long-term data reinforce positive effect of phacoemulsification for glaucoma
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A systematic review and meta-analysis confirmed the IOP-lowering effect of phacoemulsification alone in patients with primary open-angle glaucoma and the consequent reduction in the use of medications.
After search and screening, 32 studies with 1,826 patients that met the established criteria were included.
IOP reductions after phacoemulsification varied greatly among studies, ranging between 1.2% and 29.4%. Despite heterogeneity of results, an overall positive effect was observed. Mean reduction was 11.9% at 1 month, 14.4% at 1 year and 15.4% at 2 years. A decline to 9% was reported at 3 years. The authors noted that these rates are still far from the 20% to 30% reduction required to prevent progression, but are, however, “not insignificant” and “warrant, at the very least, consideration of phacoemulsification as an IOP-lowering procedure.”
A significant effect on the use of medications was also observed despite heterogeneity among studies. The overall reduction at 6 months was 0.66, slowly declining over time to 0.38 at 3 years. The authors noted that compliance issues might affect results and suggested that even a temporary effect should be considered significant in terms of reducing the medication burden and related side effects for patients.
Further studies are warranted to identify high responders, “as this patient population may have a chance to achieve adequate IOP reduction through phacoemulsification alone, thus avoiding the need for and risks associated with additional IOP-lowering procedures,” the authors wrote. They also suggested undertaking cost-effectiveness studies “to determine if there is a cost savings associated with incorporating phacoemulsification.” – by Michela Cimberle
Disclosures: The authors report no relevant financial disclosures.
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