J Korean Ophthalmol Soc.  2023 Aug;64(8):718-726. 10.3341/jkos.2023.64.8.718.

Effect of Phacoemulsification Cataract Surgery on the Clinical Outcomes of Advanced Glaucoma Patients

• Han B
• Baek SU

• KMID: 2544999
• DOI: http://doi.org/10.3341/jkos.2023.64.8.718

Abstract

Purpose
To identify the clinical outcomes of cataract surgery in patients with advanced glaucoma.
Methods
A retrospective chart review of open-angle glaucoma patients who underwent cataract surgery and were followed-up for 1 year was conducted. Advanced glaucoma was defined as a mean deviation (MD) < -12 dB on the preoperative visual field test. A group with mild-to-moderate glaucoma (MD ≥ -12 dB) served as the control group. Changes in intraocular pressure (IOP) at 1, 3, 6, and 12 months, and in the postoperative visual acuity (VA) as well as in the visual field indices (MD and the pattern standard deviation), and the number of antiglaucoma medications were compared.
Results
Eighty-seven eyes (87 patients) of the advanced group and 109 eyes (109 patients) of the mild-to-moderate group were finally included. From 1 week to 24 months postoperatively, both groups evidenced IOP decreases compared to the preoperative values (both p < 0.05). The IOP spike prevalence was similar in the two groups (11% vs. 13%, p = 0.199). The mean IOP difference between the two groups was not significant at months 1, 3, 6, 12, or 24 postoperatively (all p > 0.05). Both groups evidenced VA improvements at 1 year postoperatively and the visual field (VF) indices did not differ from those before surgery. The numbers of antiglaucoma medications used decreased after surgery, but the decrease was significant only in the advanced glaucoma group (p = 0.030).
Conclusions
The advanced and mild-to-moderate glaucoma groups evidenced similar IOP and VF changes after cataract surgery. The VA improved and the number of antiglaucoma medications decreased. Our findings suggest that cataract surgery for patients with advanced glaucoma may afford similar clinical outcomes compared to other less severe glaucoma groups.

Keyword

Cataract extraction, Glaucoma open-angle, Intraocular pressure, Treatment outcome, Visual field