Intraocular pressure changes after phacoemulsification in pseudoexfoliation versus healthy eyes
Tóm tắt
Pseudoexfoliation (PXF) syndrome is the most common cause of secondary glaucoma worldwide. This systemic disorder causes further damage to the optic nerve and ultimately increases the need for surgical interventions. Therefore, intraocular pressure (IOP) control is very important in these patients. The aim of this study was to compare IOP changes after phacoemulsification in subjects with PXF syndrome compared to those without this syndrome. 61 patients were enrolled in this prospective clinical study. Subjects were assigned into two groups based on presence or absence of PXF syndrome. IOP and anterior chamber angle parameters including: angle opening distance (AOD) and trabecular-iris surface area (TISA) measured one day preoperatively and 3 months postoperatively. Intraoperative metrics factors including: infusion fluid usage (IFU), cumulative dissipated energy (CDE) and aspiration time (AT) were obtained from the phacoemulsification machine at the end of each surgery. IOP changes, anterior chamber angle parameters and intraoperative metrics factors were compared between groups. Mean IOP before surgery was significantly higher in the PXF group (14.70 mm Hg) compared to controls (12.87 mm Hg) (P-value < 0.01). Phacoemulsification decreased IOP in both, but to greater extent in the PXF group (p-value < 0.01). AOD and TISA also increased significantly following surgery in both groups. The results showed that postoperative IOP was negatively correlated with preoperative IOP in both groups (p-value < 0.01). Also, IOP after phacoemulsification was negatively correlated with IFU in the PXF group (p-value = 0.03). Patients with PXF syndrome exhibited a reduction in IOP and increase in anterior chamber angle parameters after phacoemulsification. We observed a greater IOP reduction in PXF subjects when it was compared to controls. Higher preoperative IOP and intraoperative IFU were associated with more IOP reduction in the PXF group.
Tài liệu tham khảo
Anastasopoulos E, Founti P, Topouzis F. Update on pseudoexfoliation syndrome pathogenesis and associations with intraocular pressure, glaucoma and systemic diseases. Curr Opin Ophthalmol. 2015;26(2):82–9.
Konstas AGP, Mantziris DA, Stewart WC. Diurnal Intraocular Pressure in Untreated Exfoliation and Primary Open-angle Glaucoma. Arch Ophthalmol. 1997;115(2):182–5.
Ritch R, Schlötzer-Schrehardt U. Exfoliation Syndrome. Surv Ophthalmol. 2001;45(4):265–315.
Konstas AG, Stewart WC, Stroman GA, Sine CS. Clinical presentation and initial treatment patterns in patients with exfoliation glaucoma versus primary open-angle glaucoma. Ophthalmic Surg Lasers. 1997;28(2):111–7.
Shingleton BJ, Gamell LS, O’Donoghue MW, Baylus SL, King R. Long-term changes in intraocular pressure after clear corneal phacoemulsification: normal patients versus glaucoma suspect and glaucoma patients. J Cataract Refract Surg. 1999;25(7):885–90.
Shingleton BJ, Laul A, Nagao K, Wolff B, O’Donoghue M, Eagan E, et al. Effect of phacoemulsification on intraocular pressure in eyes with pseudoexfoliation: Single-surgeon series. J Cataract Refract Surg. 2008;34(11):1834–41.
Huang G, Gonzalez E, Lee R, Chen YC, He M, Lin SC. Association of biometric factors with anterior chamber angle widening and intraocular pressure reduction after uneventful phacoemulsification for cataract. J Cataract Refract Surg. 2012;38(1):108–16.
Latifi G, Moghimi S, Eslami Y, Fakhraie G, Zarei R, Lin S. Effect of Phacoemulsification on Drainage Angle Status in Angle Closure Eyes with or without Extensive Peripheral Anterior Synechiae. Eur J Ophthalmol. 2012;23(1):70–9.
Mansberger S, Gordon M, Jampel H, Bhorade A, Brandt J, Wilson B, et al. Reduction in intraocular pressure after cataract extraction: The ocular hypertension treatment study. Ophthalmology. 2012;119(9):1826–31.
Jimenez-Roman J, Lazcano-Gomez G, Martínez-Baez K, Turati M, Gulías-Cañizo R, Hernández-Zimbrón LF, et al. Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma. Int J Ophthalmol. 2017;10(9):1374–8.
Armstrong JJ, Wasiuta T, Kiatos E, Malvankar-Mehta M, Hutnik CML. The effects of phacoemulsification on intraocular pressure and topical medication use in patients with Glaucoma: a systematic review and meta-analysis of 3-Year data. J Glaucoma. 2017;26(6):511–22.
Rao A. Diurnal Curve after Phacoemulsification in Patients with Pseudoexfoliation Syndrome and Cataract. Seminars in Ophthalmology. 2012;27(1–2):1–5.
Vahedian Z, Salmanroghani R, Fakhraie G, Moghimi S, Eslami Y, Zarei R, et al. Pseudoexfoliation syndrome: Effect of phacoemulsification on intraocular pressure and its diurnal variation. Journal of Current Ophthalmology. 2015;27(1):12–5.
Damji KF, Konstas AG, Liebmann JM, Hodge WG, Ziakas NG, Giannikakis S, et al. Intraocular pressure following phacoemulsification in patients with and without exfoliation syndrome: a 2 year prospective study. Br J Ophthalmol. 2006;90(8):1014–8.
Chen PP, Lin SC, Junk AK, Radhakrishnan S, Singh K, Chen TC. The effect of phacoemulsification on intraocular pressure in glaucoma patients: a report by the american academy of ophthalmology. Ophthalmology. 2015;122(7):1294–307.
Moghimi S, Johari M, Mahmoudi A, Chen R, Mazloumi M, He M, et al. Predictors of intraocular pressure change after phacoemulsification in patients with pseudoexfoliation syndrome. Br J Ophthalmol. 2017;101(3):283–9.
Nolan W. Anterior segment imaging: ultrasound biomicroscopy and anterior segment optical coherence tomography. Curr Opin Ophthalmol. 2008;19(2):115–21.
Mansouri M, Ramezani F, Moghimi S, Tabatabaie A, Abdi F, He M, et al. Anterior segment optical coherence tomography parameters in phacomorphic angle closure and mature cataracts. Invest Ophthalmol Vis Sci. 2014;55(11):7403–9.
Moghimi S, Ramezani F, He M, Coleman AL, Lin SC. Comparison of anterior segment-optical coherence tomography parameters in phacomorphic angle closure and acute angle closure eyes. Invest Ophthalmol Vis Sci. 2015;56(13):7611–7.
Damji KF. Progress in understanding pseudoexfoliation syndrome and pseudoexfoliation-associated glaucoma. Can J Ophthalmol. 2007;42(5):657–8.
Moghimi S, Abdi F, Latifi G, Fakhraie G, Ramezani F, He M, et al. Lens parameters as predictors of intraocular pressure changes after phacoemulsification. Eye. 2015;29(11):1469–76.
Poley BJ, Lindstrom RL, Samuelson TW, Schulze R Jr. Intraocular pressure reduction after phacoemulsification with intraocular lens implantation in glaucomatous and nonglaucomatous eyes: evaluation of a causal relationship between the natural lens and open-angle glaucoma. J Cataract Refract Surg. 2009;35(11):1946–1955.
Issa SA, Pacheco J, Mahmood U, Nolan J, Beatty S. A novel index for predicting intraocular pressure reduction following cataract surgery. Br J Ophthalmol. 2005;89(5):543–546.
Lee RY, Chen RI, Kasuga T, Cui QN, Porco TC, Lin SC. The effect of cumulative dissipated energy on changes in intraocular pressure after uncomplicated cataract surgery by phacoemulsification. J Glaucoma. 2016;25(7):565–70.
Alaghband P, Beltran-Agulló L, Galvis EA, Overby DR, Lim KS. Effect of phacoemulsification on facility of outflow. Br J Ophthalmol. 2018;102(11):1520–1526.