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Intra‐ocular pressure fluctuation after cataract surgery in primary angle‐closure glaucoma eyes medically controlled after laser iridotomy
Author(s) -
Özyol Pelin,
Özyol Erhan,
Sül Sabahattin,
Baldemir Ercan,
Çavdar Sabanur
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13023
Subject(s) - medicine , ophthalmology , angle closure glaucoma , glaucoma , intraocular pressure , cataract surgery , closure (psychology) , optometry , market economy , economics
Purpose To analyse the effect of cataract surgery on diurnal intra‐ocular pressure ( IOP ) fluctuation in primary angle‐closure glaucoma ( PACG ) eyes. Methods Thirty‐nine eyes of 24 patients with PACG scheduled for cataract surgery were enrolled to this prospective study. A record was made which included mean IOP measurement, anterior chamber depth ( ACD ), anterior chamber angle ( ACA ), number of antiglaucomatous medications, visual field analysis (mean deviation – MD and pattern standard deviation – PSD ) and responses to the Glaucoma Quality of Life‐15 ( GQL ‐15) questionnaires. The eyes were re‐evaluated at 2 and 3 months of cataract surgery. Results IOP fluctuation was decreased from 4.58 ± 2.07 mmHg to 2.84 ± 1.5 mmHg (p < 0.001). The decrease in mean IOP , the number of glaucoma eye drops required (p < 0.001, p = 0.012, respectively) and the increase in mean ACD , ACA grading and SITA ‐standard MD (p < 0.001, p < 0.001, and p = 0.01, respectively) were statistically significant. The mean GQL ‐15 score was also improved (p < 0.001). The change in IOP fluctuation correlated positively with the preoperative IOP fluctuation ( r = 0.56 p = 0.00), the change in ACD ( r = 0.703, p < 0.001) and the change in ACA ( r = 0.664, p < 0.001). In multivariate analysis, preoperative IOP fluctuation and postoperative increase in ACD were significantly associated with a reduction in IOP fluctuation of an average of 1.1 mmHg per unit change (p = 0.00 and p = 0.019, respectively). Conclusions Cataract surgery in PACG provides the opportunity to address many pathologies with one intervention; improving vision, diminishing IOP , blunting IOP fluctuation, reducing need for medications, eliminating a narrow angle and improving GQL ‐15 scores.