J Korean Ophthalmol Soc.  2013 Aug;54(8):1193-1198.

Influence of Phacoemulsification on Progression of Glaucoma and Analysis of Related Factors in Glaucoma Patients

• Yoo GY
• Hwang HB
• Park MH
• Kim HS

Abstract

PURPOSE
To evaluate the factors affecting glaucoma progression after cataract surgery with phacoemulsification.
METHODS
The medical charts of 109 eyes of 68 patients with glaucoma who had phacoemulsification were retrospectively reviewed. The course of glaucoma was followed up for at least 2 years. Age, sex, diabetes, hypertension, preoperative mean deviation, phacoemulsification time, cataract type, refractive error, preoperative and postoperative visual acuity, preoperative and postoperative intraocular pressure, axial length, and central corneal thickness between the progression group and the non-progression group were compared.
RESULTS
Among 109 eyes with glaucoma, 19 (17.4%) eyes were classified into the glaucoma progression group. In the multivariate analysis, age (p = 0.026), preoperative mean deviation (p < 0.001), and phacoemulsification time (p < 0.001) were statistically associated with glaucoma progression.
CONCLUSIONS
For patients with glaucoma, phacoemulsification may result in its progression. Special attention should be given to patients with the above risk factors.

Keyword

Cataract; Glaucoma; Phacoemulsification

MeSH Terms

Cataract
Eye
Glaucoma
Humans
Hypertension
Intraocular Pressure
Multivariate Analysis
Phacoemulsification
Refractive Errors
Retrospective Studies
Risk Factors
Visual Acuity

Reference

References

1. Lichter PR, Musch DC, Gillespie BW. . Interim clinical out-comes in the Collaborative Initial Glaucoma Treatment Study com-paring initial treatment randomized to medications or surgery. Ophthalmology. 2001; 108:1943–53.

2. Kim YY, Kim JS, Shin DH. . Effect of cataract extraction on blue-on-yellow visual field. Am J Ophthalmol. 2001; 132:217–20.

3. Chen PP, Budenz DL. The effects of cataract extraction on the visu-al field of eyes with chronic open-angle glaucoma. Am J Ophthalmol. 1998; 125:325–33.

4. Hayashi K, Hayashi H, Nakao F, Hayashi F. Influence of cataract surgery on automated perimetry in patients with glaucoma. Am J Ophthalmol. 2001; 132:41–6.

5. Lam BL, Alward WL, Kolder HE. Effect of cataract on automated perimetry. Ophthalmology. 1991; 98:1066–70.

6. Lee KS, Park JW. Effect of cataract extraction on visual field test in patients with glaucoma. J Korean Ophthalmology Soc. 2010; 51:55–62.

7. Anderson DR. Automated static perimetry. 1st ed.St. Louis: Mosby;1992; 25–30.

8. Jahn CE. Reduced intraocular pressure after phacoemulsification and posterior chamber intraocular lens implantation. J Cataract Refract Surg. 1997; 23:1260–4.

9. Liu CJ, Cheng CY, Wu CW. . Factors predicting intraocular pressure control after phacoemulsification in angle-closure glaucoma. Arch Ophthalmol. 2006; 124:1390–4.

10. Park S, Lee M, Ahn J. Relationship between preoperative biometry and intraocular pressure reduction after phacoemulsification in normal and glaucoma patients. J Korean Ophthalmol Soc. 2012; 53:111–9.

11. Rand Allingham R, Moroi SE. Surgical approaches for coexisting glaucoma and cataract. In: Rand Allingham R, Damji KF, Sharon Freedman, Moroi SE, Bruce Shields, eds. Shield's Textbook of Glaucoma. 6th ed.Philadelphia: Lippincott Wiliams & Wilkins;2010; chap. 41.

12. Leske MC, Heijl A, Hyman L. . Factors for progression and glaucoma treatment: the Early Manifest Glaucoma Trial. Curr Opin Ophthalmol. 2004; 15:102–6.

13. Koucheki B, Nouri-Mahdavi K, Patel G. . Visual field changes after cataract extraction: the AGIS experience. Am J Ophthalmol. 2004; 138:1022–8.

14. Oshika T, Yoshimura K, Miyata N. Postsurgical inflammation after phacoemulsification and extracapsular extraction with soft or con-ventional intraocular lens implantation. J Cataract Refract Surg. 1992; 18:356–61.

15. Pande MV, Spalton DJ, Kerr-Muir MG, Marshall J. Postoperative inflammatory response to phacoemulsification and extracapsular cataract surgery: aqueous flare and cells. J Cataract Refract Surg. 1996; 22 Suppl. 1:770–4.

16. Ohrloff C, Zubcov AA. Comparison of phacoemulsification and planned extracapsular extraction. Ophthalmologica. 1997; 211:8–12.

17. Kreutzer TC, Al Saeidi R, Kampik A, Grueterich M. Real-time in-traocular pressure measurement in standard and microcoaxial phacoemulsification. J Cataract Refract Surg. 2010; 36:53–7.

18. McCulley TJ, Lam BL, Feuer WJ. Incidence of nonarteritic ante-rior ischemic optic neuropathy associated with cataract extraction. Ophthalmology. 2001; 108:1275–8.

19. McCulley TJ, Lam BL, Feuer WJ. Nonarteritic anterior ischemic optic neuropathy and surgery of the anterior segment: temporal re-lationship analysis. Am J Ophthalmol. 2003; 136:1171–2.

20. Lee H, Kim CY, Seong GJ, Ma KT. A case of decreased visual field after uneventful cataract surgery: nonarteritic anterior ischemic op-tic neuropathy. Korean J Ophthalmol. 2010; 24:57–61.