J Korean Ophthalmol Soc.  2019 May;60(5):463-469. 10.3341/jkos.2019.60.5.463.

Effect of Preoperative Factors and Gonioscopy on Intraocular Pressure Reduction after Phacoemulsification in Glaucoma

• Park Y
• Kim YB
• Cho KJ

• KMID: 2445140
• DOI: http://doi.org/10.3341/jkos.2019.60.5.463

Abstract

PURPOSE
To evaluate a new gonioscopy score and preoperative factors as a potential predictor for intraocular pressure (IOP) reduction after phacoemulsification.
METHODS
This is a retrospective review of 182 eyes with glaucoma of either open or narrow angles that underwent phacoemulsification. Preoperative variables such as age, IOP, refractive errors, anterior chamber depth (ACD), axial length, and lens position were evaluated at 6 months after surgery. A preoperative gonioscopy score was created, summing the Shaffer gonioscopy grading in 4 quadrants. To determine variables associated with IOP change at 6 months, univariate and multivariate linear regression analysis was performed.
RESULTS
The mean age of the patients was 72.8 ± 9.5 years and the average preoperative IOP was 16.4 ± 3.7 mmHg with 1.2 glaucoma medications. The mean IOP reduction after phacoemulsification was 2.7 ± 2.2 mmHg at postoperative 6 months. Preoperative IOP (β = 0.55, p < 0.001), gonioscopy score (β = −0.29, p < 0.001), ACD (β = −0.67, p = 0.02), and IOP/ACD ratio (β = 0.58, p = 0.01) were associated with IOP reduction at 6 months.
CONCLUSIONS
Preoperative predictors for IOP reduction after phacoemulsification were preoperative IOP, ACD, gonioscopy score, and IOP/ACD ratio in patients with glaucoma. The IOP/ACD ratio and gonioscopy score can be easy parameters to obtain and may help clinicians to estimate the IOP reduction after phacoemulsification.

Keyword

Glaucoma; Gonioscopy; Intraocular pressure; Phacoemulsification

MeSH Terms

Anterior Chamber
Glaucoma*
Gonioscopy*
Humans
Intraocular Pressure*
Linear Models
Phacoemulsification*
Refractive Errors
Retrospective Studies

Figure

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  Figure 1. The relationship between significant preoperative predictors with IOP reduction following phacoemulsification after multivariate analysis. (A) Relationship between preoperative IOP and IOP reduction. (B) Relationship between gonioscopy score and IOP reduction. (C) Relationship between preoperative ACD and IOP reduction. (D) Relationship between IOP/ACD ratio and IOP reduction are presented. IOP = intraocular pressure; ACD = anterior chamber depth.

Reference

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