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Primary phacoemulsification and intraocular lens implantation for acute primary angle-closure.

Su WW, Chen PY, Hsiao CH, Chen HS - PLoS ONE (2011)

Bottom Line: The postoperative IOP was reduced in 16 eyes (100%).The mean number of antiglaucoma medications decreased from 3.56 ± 1.14 to 0.13 ± 0.34 (p < 0.001).Visual acuity (converted into logarithm of the minimum angle of resolution [logMAR]) improved from 1.14 ± 0.71 to 0.73 ± 0.53 (p =  0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.

ABSTRACT

Background: To investigate the effect of primary phacoemulsification on intraocular pressure (IOP) in patients with acute primary angle-closure (PAC) and coexisting cataract.

Methodology: Sixteen eyes of 14 patients with acute PAC received phacoemulsification and intraocular lens implantation as initial management for medically uncontrolled IOP in a retrospective chart review. The effects on IOP, vision, anterior chamber depth (ACD), and number of antiglaucoma medications were evaluated.

Principal findings: The postoperative IOP was reduced in 16 eyes (100%). The mean ± standard deviation preoperative IOP was 48.81 ± 16.83 mm Hg, which decreased postoperatively to 16.46 ± 10.67 mm Hg at 1 day, 9.43 ± 3.03 mm Hg at 1 week, 9.49 ± 2.14 mm Hg at 2 weeks, 10.78 ± 3.56 mm Hg at 1 month, and 10.70 ± 2.80 mm Hg at 3 months (p < 0.001). The mean number of antiglaucoma medications decreased from 3.56 ± 1.14 to 0.13 ± 0.34 (p < 0.001). The average preoperative ACD was 2.08 ± 0.35 mm, which increased to 3.59 ± 0.33 mm after surgery (p < 0.001). Visual acuity (converted into logarithm of the minimum angle of resolution [logMAR]) improved from 1.14 ± 0.71 to 0.73 ± 0.53 (p =  0.001).

Conclusions: Primary phacoemulsification plus intraocular lens implantation lowered IOP, reduced the use of antiglaucoma medications, and improved vision in patients with acute PAC. This is a safe and effective method of IOP control and can be considered a first treatment option in managing patients with acute PAC and coexisting cataract.

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Intraocular pressure changes after phacoemulsification+intraocular lens implantation.
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pone-0020056-g001: Intraocular pressure changes after phacoemulsification+intraocular lens implantation.

Mentions: The mean ± SD age of the patients was 72.63±3.72 years. Five patients (35.7%) were male and nine (64.3%) were female. Most of the patients underwent surgery within 2 weeks after the acute PAC attack, with an average interval of 12.94±9.12 days. The mean IOP at the time of acute PAC attack was 48.81±16.83 mm Hg, which decreased significantly after surgery as follows: 1 day, 16.46±10.67 mm Hg, 1 week, 9.43±3.03 mm Hg, 2 weeks, 9.49±2.14 mm Hg, 1 month, 10.78±3.56 mm Hg, and 3 months, 10.70±2.80 mm Hg. A repeated measure one-way ANOVA with a Greenhouse-Geisser correction determined that IOP differed statistically significantly between time points (p<0.001) (Figure 1, Table 1). The mean number of antiglaucoma medications decreased from 3.56±1.41 preoperatively to 0.13±0.34 postoperatively (p<0.001). The preoperative BCVA (converted into logMAR) was 1.14±0.71, and the postoperative value was 0.73±0.53 (p = 0.001). The mean ACD increased from 2.08±0.35 mm preoperatively to 3.59±0.33 mm postoperatively (p<0.001). The preoperative spherical equivalent was −2.07±2.85 D, and the postoperative value was −0.25±1.16 D (p = 0.068). The average implanted IOL power was 22.63±2.69 D (Table 1). There were no significant postoperative complications. Transient IOP spikes were observed in two cases (12.5%).


Primary phacoemulsification and intraocular lens implantation for acute primary angle-closure.

Su WW, Chen PY, Hsiao CH, Chen HS - PLoS ONE (2011)

Intraocular pressure changes after phacoemulsification+intraocular lens implantation.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3101225&req=5

pone-0020056-g001: Intraocular pressure changes after phacoemulsification+intraocular lens implantation.
Mentions: The mean ± SD age of the patients was 72.63±3.72 years. Five patients (35.7%) were male and nine (64.3%) were female. Most of the patients underwent surgery within 2 weeks after the acute PAC attack, with an average interval of 12.94±9.12 days. The mean IOP at the time of acute PAC attack was 48.81±16.83 mm Hg, which decreased significantly after surgery as follows: 1 day, 16.46±10.67 mm Hg, 1 week, 9.43±3.03 mm Hg, 2 weeks, 9.49±2.14 mm Hg, 1 month, 10.78±3.56 mm Hg, and 3 months, 10.70±2.80 mm Hg. A repeated measure one-way ANOVA with a Greenhouse-Geisser correction determined that IOP differed statistically significantly between time points (p<0.001) (Figure 1, Table 1). The mean number of antiglaucoma medications decreased from 3.56±1.41 preoperatively to 0.13±0.34 postoperatively (p<0.001). The preoperative BCVA (converted into logMAR) was 1.14±0.71, and the postoperative value was 0.73±0.53 (p = 0.001). The mean ACD increased from 2.08±0.35 mm preoperatively to 3.59±0.33 mm postoperatively (p<0.001). The preoperative spherical equivalent was −2.07±2.85 D, and the postoperative value was −0.25±1.16 D (p = 0.068). The average implanted IOL power was 22.63±2.69 D (Table 1). There were no significant postoperative complications. Transient IOP spikes were observed in two cases (12.5%).

Bottom Line: The postoperative IOP was reduced in 16 eyes (100%).The mean number of antiglaucoma medications decreased from 3.56 ± 1.14 to 0.13 ± 0.34 (p < 0.001).Visual acuity (converted into logarithm of the minimum angle of resolution [logMAR]) improved from 1.14 ± 0.71 to 0.73 ± 0.53 (p =  0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.

ABSTRACT

Background: To investigate the effect of primary phacoemulsification on intraocular pressure (IOP) in patients with acute primary angle-closure (PAC) and coexisting cataract.

Methodology: Sixteen eyes of 14 patients with acute PAC received phacoemulsification and intraocular lens implantation as initial management for medically uncontrolled IOP in a retrospective chart review. The effects on IOP, vision, anterior chamber depth (ACD), and number of antiglaucoma medications were evaluated.

Principal findings: The postoperative IOP was reduced in 16 eyes (100%). The mean ± standard deviation preoperative IOP was 48.81 ± 16.83 mm Hg, which decreased postoperatively to 16.46 ± 10.67 mm Hg at 1 day, 9.43 ± 3.03 mm Hg at 1 week, 9.49 ± 2.14 mm Hg at 2 weeks, 10.78 ± 3.56 mm Hg at 1 month, and 10.70 ± 2.80 mm Hg at 3 months (p < 0.001). The mean number of antiglaucoma medications decreased from 3.56 ± 1.14 to 0.13 ± 0.34 (p < 0.001). The average preoperative ACD was 2.08 ± 0.35 mm, which increased to 3.59 ± 0.33 mm after surgery (p < 0.001). Visual acuity (converted into logarithm of the minimum angle of resolution [logMAR]) improved from 1.14 ± 0.71 to 0.73 ± 0.53 (p =  0.001).

Conclusions: Primary phacoemulsification plus intraocular lens implantation lowered IOP, reduced the use of antiglaucoma medications, and improved vision in patients with acute PAC. This is a safe and effective method of IOP control and can be considered a first treatment option in managing patients with acute PAC and coexisting cataract.

Show MeSH
Related in: MedlinePlus