Long-term intraocular pressure change after clear corneal phacoemulsification in thai glaucoma patients

Abstract

Objectives: To evaluate long-term intraocular pressure (IOP) changes after sutureless clear corneal phacoemulsification in eyes with preoperatively controlled glaucoma. Design: Retrospective study. Setting: Eye clinic, Ramathibodi Hospital, Faculty of Medicine, Mahidol University. Material and Method: The medical records of 218 patients who had uneventful sutureless clear corneal phacoemulsification with acrylic foldable lens (IOL) implantation were retrospectively reviewed. Included were 58 patients with medically controlled open-angle glaucoma and 160 normal controls. Follow-up was 12 to 18 months. Outcome measures were postoperative IOP and number of glaucoma medications. Results: Postoperatively, there was an insignificant decrease in IOP in the glaucoma group; the mean decrease was 1.4 mm Hg ± 3.8 (SD) at 12 months and 1.6 ± 4.2 mm Hg at 18months. The mean number of medications decreased significantly at 12 months (0.51 ± 0.75) and at 18 months (0.41 ± 0.83) (P = .04). The control group also had a significant decrease in IOP, with a mean decrease of 0.83 ± 2.8 mm Hg at 12 months (P = .01) and 1.26 ± 2.9 mm Hg at 18 months (P < .0001). The decrease in IOP was more pronounced in eyes with a higher preoperative IOP in both the glaucoma and control groups. Conclusion: These findings suggest that sutureless clear corneal phacoemulsification with foldable acrylic IOL implantation is a relatively safe and simple surgical option in patients with cataract and well-controlled glaucoma. The approach provided favorable long-term IOP change and led to rapid visual rehabilitation in both the glaucoma and control group.