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Kouroupaki AI, Triantafyllopoulos GI, Pateras E, Karabatsas CH, Plakitsi A. Anterior Segment Changes in Patients With Glaucoma Following Cataract Surgery. Cureus 2024; 16:e58703. [PMID: 38779247 PMCID: PMC11110096 DOI: 10.7759/cureus.58703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/25/2024] Open
Abstract
This prospective observational study investigates the impact of cataract surgery on anterior segment parameters in nonglaucomatous and primary open-angle glaucoma (POAG) eyes, utilizing anterior segment optical coherence tomography (AS-OCT). The study involved 42 Caucasian patients, divided into a control group and a POAG group. Comprehensive ophthalmic examinations were performed along with AS-OCT imaging and biometry preoperatively, as well as on one day, one week, and one month following cataract surgery. The results showed significant post-operative changes in anterior chamber depth (ACD) and angle width in both groups, suggesting that cataract surgery may influence the structural parameters associated with glaucoma risk and management. Specifically, a marked increase in ACD and improvement in angle-opening distances were observed, highlighting the potential of cataract extraction to alter intraocular fluid dynamics favorably. Despite these changes, the study noted an initial spike in increased intraocular pressure (IOP) in POAG patients immediately post-operative, which stabilized during follow-up. For the control group, IOP showed gradually reducing IOP values in the follow-up visits. The findings underscore the role of advanced imaging technologies in understanding glaucoma's pathophysiology and the potential benefits of cataract surgery in glaucoma patients. The study advocates for further research with a larger, more diverse patient population and extended follow-up to explore the long-term implications of cataract surgery on glaucoma dynamics, emphasizing the importance of personalized management and treatment strategies particularly for glaucoma patients.
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Affiliation(s)
- Anna I Kouroupaki
- Biomedical Sciences Department, Course of Optics and Optometry, University of West Attica, Athens, GRC
- Ophthalmology Department, 'Korgialenio-Benakio' Hellenic Red Cross General Hospital, Athens, GRC
| | | | - Evangelos Pateras
- Biomedical Sciences Department, Course of Optics and Optometry, University of West Attica, Athens, GRC
| | - Costas H Karabatsas
- Biomedical Sciences Department, Course of Optics and Optometry, University of West Attica, Athens, GRC
| | - Athina Plakitsi
- Biomedical Sciences Department, Course of Optics and Optometry, University of West Attica, Athens, GRC
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Ang BCH, Chiew W, Yip VCH, Chua CH, Han WS, Tecson IOC, Ogle JJ, Lim BA, Hee OK, Tay ELY, Yong VKY, Wong HT, Yip LWL. Prospective 12-month outcomes of combined iStent inject implantation and phacoemulsification in Asian eyes with normal tension glaucoma. EYE AND VISION (LONDON, ENGLAND) 2022; 9:27. [PMID: 35794666 PMCID: PMC9258099 DOI: 10.1186/s40662-022-00294-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/04/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Glaucoma is the leading cause of irreversible blindness. Normal tension glaucoma (NTG) is a subset of open-angle glaucoma, demonstrating glaucomatous optic nerve damage in the absence of raised intraocular pressure (IOP). NTG is more prevalent in Asian populations. While generally slow-progressing, NTG may be associated with significant central visual field loss. In recent years, minimally invasive glaucoma surgery has been added to the armamentarium of glaucoma surgery. This prospective study aims to evaluate 12-month surgical outcomes of combined iStent inject (Glaukos Corporation, Laguna Hills, CA) implantation and phacoemulsification in Asian eyes with NTG. METHODS This is a prospective, single-centre case series of 30 eyes followed up until 12 months after surgery. Outcome measures included IOP, number of glaucoma medications, best-corrected visual acuity (BCVA) and intra and postoperative complications. RESULTS Mean age of subjects was 73.1 ± 6.3 years. Majority were ethnic Chinese (n = 27, 90%). Baseline medicated mean IOP was 13.8 ± 2.4 mmHg and mean number of glaucoma medications was 1.3 ± 0.7. Mean Humphrey visual field mean deviation was - 13.7 ± 7.6. The mean IOP reduction at all timepoints from postoperative month (POM) 3 onwards was statistically significant (all P < 0.05), with mean reduction of 1.2 mmHg (95% CI: 0.1-2.2, P = 0.037) by POM12. There was statistically significant reduction in mean number of medications from postoperative day (POD) 1 onwards (all P < 0.05), with mean decrease of 1.0 medication (95% CI: 0.9-1.1, P < 0.001) by POM12. By POM12, 25 (83.3%) eyes were medication-free. Three (10%) eyes had stent occlusion by iris requiring laser iridoplasty. One eye had gross hyphema which resolved on conservative management before POM1. Mean BCVA improved from the baseline 0.3 ± 0.3 logMAR to 0.1 ± 0.1 logMAR postoperatively (P < 0.001). There were no major adverse or sight-threatening events. No eyes required further glaucoma surgery during the 12-month follow-up period. CONCLUSION Asian eyes with NTG which underwent combined iStent inject implantation and phacoemulsification demonstrated a significant and sustained reduction in IOP and glaucoma medications, up to 12 months postoperatively.
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Affiliation(s)
- Bryan Chin Hou Ang
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.
- National Healthcare Group Eye Institute, Woodlands Health Campus, Singapore, Singapore.
| | - Wenqi Chiew
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Vivien Cherng Hui Yip
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Chun Hau Chua
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Wei Shan Han
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Ivan O'Neill C Tecson
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
- Cardinal Santos Medical Centre, Manila, Philippines
| | - Jeanne Joyce Ogle
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Boon Ang Lim
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Elton Lik Yong Tay
- National Healthcare Group Eye Institute, Woodlands Health Campus, Singapore, Singapore
| | - Vernon Khet Yau Yong
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Hon Tym Wong
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Leonard Wei Leon Yip
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
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Schuster AK, Nickels S, Pfeiffer N, Schmidtmann I, Wild PS, Münzel T, Beutel ME, Lackner KJ, Vossmerbaeumer U. Frequency of cataract surgery and its impact on visual function-results from the German Gutenberg Health Study. Graefes Arch Clin Exp Ophthalmol 2020; 258:2223-2231. [PMID: 32514772 PMCID: PMC7550321 DOI: 10.1007/s00417-020-04770-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/21/2020] [Accepted: 05/25/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose To determine the frequency of cataract surgery in Germany and to evaluate its impact on visual function in an adult population. Methods The population-based Gutenberg Health Study was conducted in Germany with its baseline examination between 2007 and 2012 and a 5-year follow-up examiantion. An ophthalmological examination including slit-lamp examination, ocular biometry, and Scheimpflug imaging was carried out. Overall and age-specific frequencies of unilateral and bilateral cataract surgery within 5 years were computed including the 95% confidential intervals [95%-CI]. Association analyses were conducted to determine social and ocular associated factors using multivariable logistic regression analysis. Vision-related quality of life was assessed using NEI VFQ-25. Results A total of 10,544 people aged 35 to 74 years were bilateral phakic at baseline and had information on lens status at the 5-year examination. Of these, 168 had unilateral cataract surgery (1.6% [1.4–1.9%]), and 448 had bilateral cataract surgery (4.2% [3.9–4.7%]) in the following 5 years. The frequency of cataract surgery increased with age: 45–54-year-old subjects had twice as often cataract surgery (in at least on eye: OR = 2.32) than at age 35–44 years. The frequency further strongly increases with age (55–64 years: OR = 10.5; 65–74 years: OR = 43.8, p < 0.001). Subjects with glaucoma were more likely to have cataract surgery (OR = 2.52, p < 0.001). Visual function increased when undergoing bilateral cataract surgery. Conclusions The frequency of cataract surgery is low at younger ages and increases up to 26% at age 70–74 years. Persons with glaucoma are more likely to undergo cataract surgery at population-based level in Germany. Electronic supplementary material The online version of this article (10.1007/s00417-020-04770-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany.
| | - S Nickels
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - N Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - I Schmidtmann
- Institute of Biomedical Statistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P S Wild
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- DZHK (German Center for Cardiovascular Research), partner site Rhine-Main, Mainz, Germany
| | - T Münzel
- Center for Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - K J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
| | - U Vossmerbaeumer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
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Intraocular Pressure Changes and Frequency of IOP Spike After Cataract Surgery in Normal-tension Glaucoma: A Case-Control Study. J Glaucoma 2019; 29:e16. [DOI: 10.1097/ijg.0000000000001431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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