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Qassim A, Walland MJ, Landers J, Awadalla M, Nguyen T, Loh J, Schulz AM, Ridge B, Galanopoulos A, Agar A, Hewitt AW, Graham SL, Healey PR, Casson RJ, Craig JE. Effect of phacoemulsification cataract surgery on intraocular pressure in early glaucoma: A prospective multi‐site study. Clin Exp Ophthalmol 2020; 48:442-449. [DOI: 10.1111/ceo.13724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/19/2020] [Accepted: 01/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ayub Qassim
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Mark J. Walland
- Glaucoma Investigation and Research UnitRoyal Victorian Eye and Ear Hospital Melbourne Victoria Australia
| | - John Landers
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Mona Awadalla
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Thi Nguyen
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Jason Loh
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Angela M. Schulz
- Faculty of Medicine and Health SciencesMacquarie University Sydney New South Wales Australia
| | - Bronwyn Ridge
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Anna Galanopoulos
- South Australian Institute of OphthalmologyRoyal Adelaide Hospital Adelaide New South Wales Australia
| | - Ashish Agar
- Department of OphthalmologyPrince of Wales Hospital Sydney New South Wales Australia
| | - Alex W. Hewitt
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Tasmania Australia
| | - Stuart L. Graham
- Faculty of Medicine and Health SciencesMacquarie University Sydney New South Wales Australia
| | - Paul R. Healey
- Centre for Vision ResearchWestmead Institute for Medical Research, University of Sydney Sydney New South Wales Australia
| | - Robert J. Casson
- South Australian Institute of OphthalmologyUniversity of Adelaide Adelaide South Australia Australia
| | - Jamie E. Craig
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
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Anterior chamber angle and intraocular pressure changes after eventless phacoemulsification surgery in non-glaucomatous Egyptian patients. Int Ophthalmol 2019; 40:725-731. [DOI: 10.1007/s10792-019-01234-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/16/2019] [Indexed: 11/26/2022]
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Kudsieh B, Fernández-Vigo JI, Vila-Arteaga J, Urcola JA, Martínez-de-la-Casa JM, García-Feijóo J, Ruiz-Moreno JM, Fernández-Vigo JÁ. Update on the usefulness of optical coherence tomography in assessing the iridocorneal angle. ACTA ACUST UNITED AC 2019; 94:478-490. [PMID: 31371112 DOI: 10.1016/j.oftal.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Abstract
The iridocorneal angle, due to its implications in the physiopathology of aqueous humour drainage, is a fundamental structure of the anterior chamber. Anterior segment optical coherence tomography is a rapid and non-invasive technique that obtains images in vivo. The high resolution allows it to analyse the normal anatomy of the angle, any alterations, and the changes that occur after different therapeutic interventions. Anterior segment optical coherence tomography technology has evolved to provide images that allow the identification and quantification of the angular structures in healthy subjects and in glaucoma patients, and especially the trabecular meshwork and the Schlemm's canal. It also enables the angle width to be quantified, with some objective parameters that have been standardised in recent years, such as the trabecular-iris angle, the angle opening distance, and the trabecular-iris area. This technique has multiple uses in the study of the different mechanisms of angle closure, the evaluation of changes after a laser peripheral iridotomy or iridoplasty after cataract surgery, as well as after the implantation of phakic lenses.
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Affiliation(s)
- B Kudsieh
- Departamento de Oftalmología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España; Centro Internacional de Oftalmología Avanzada, Madrid, España.
| | - J I Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, España; Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, España
| | - J Vila-Arteaga
- Hospital La Fe, Valencia, España; Clínica Vila-Innova Ocular, Valencia, España
| | - J Aritz Urcola
- Departamento de Oftalmología, Hospital Universitario de Álava, Vitoria, España; Begitek Clínica Oftalmológica, Innova Ocular, Donostia-San Sebastián, España
| | - J M Martínez-de-la-Casa
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, España
| | - J García-Feijóo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, España
| | - J M Ruiz-Moreno
- Departamento de Oftalmología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - J Á Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, España; Departamento de Oftalmología, Universidad de Extremadura, Badajoz, España
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Lee W, Bae HW, Kim CY, Seong GJ. The change of anterior segment parameters after cataract surgery in normal-tension glaucoma. Int J Ophthalmol 2017; 10:1239-1245. [PMID: 28861349 DOI: 10.18240/ijo.2017.08.09] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/06/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the change of anterior chamber angle morphology and intraocular pressure (IOP) reduction after cataract surgery in patients with normal-tension glaucoma (NTG) using swept-source optical coherence tomography (SS-OCT). METHODS This prospective, comparative, observational study recruited patients into two groups. Group 1 was the control group including normal subjects except those with cataracts (cataract group, n=67 eyes of 67 patients), and group 2 was NTG group including patients who were diagnosed with NTG and cataracts (n=43 eyes of 43 patients), which were treated with phacoemulsification and intraocular lens implantation. Before surgery, and at postoperative 1 and 6mo, anterior chamber angles were evaluated by SS-OCT under dark conditions using three-dimensional angle analysis scan protocol. Angle opening distance (AOD), angle recess area (ARA), and trabecular-iris surface area (TISA) at four quadrants (temporal, nasal, superior, and inferior) were calculated automatically by SS-OCT, after the observer marked scleral spurs. RESULTS A total of 106 patients (54 males and 52 females) were enrolled in the study. Angle parameters, AOD, ARA, and TISA were increased after surgery in both groups. However, changes of angle parameters were only significant in group 2. In group 2, preoperative IOP was 13.2±2.9 mm Hg, and postoperative IOP at 1 and 6mo were 10.5±3.0 and 10.7±2.8 mm Hg, respectively. In group 1, preoperative IOP was 12.4±2.8 mm Hg, and postoperative IOP at 1 and 6mo were 11.6±2.5 and 12.0±2.8 mm Hg, respectively. After cataract surgery, angle parameters changed significantly while IOP significantly reduced and was maintained in group 2 (P<0.001). The changes in angle parameters (ΔAOD500, ΔTISA500 at temporal; ΔAOD500, ΔARA500 at nasal) were linearly correlated with postoperative IOP changes. CONCLUSION Cataract surgery may have improved anterior chamber angle parameters and decreased IOP in NTG patients.
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Affiliation(s)
- Wonseok Lee
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Hyoung Won Bae
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Chan Yun Kim
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Gong Je Seong
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul 03722, Korea
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Lee W, Bae HW, Lee SH, Kim CY, Seong GJ. Correlations between Preoperative Angle Parameters and Postoperative Unpredicted Refractive Errors after Cataract Surgery in Open Angle Glaucoma (AOD 500). Yonsei Med J 2017; 58:432-438. [PMID: 28120576 PMCID: PMC5290025 DOI: 10.3349/ymj.2017.58.2.432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/07/2016] [Accepted: 10/15/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To assess the accuracy of intraocular lens (IOL) power prediction for cataract surgery with open angle glaucoma (OAG) and to identify preoperative angle parameters correlated with postoperative unpredicted refractive errors. MATERIALS AND METHODS This study comprised 45 eyes from 45 OAG subjects and 63 eyes from 63 non-glaucomatous cataract subjects (controls). We investigated differences in preoperative predicted refractive errors and postoperative refractive errors for each group. Preoperative predicted refractive errors were obtained by biometry (IOL-master) and compared to postoperative refractive errors measured by auto-refractometer 2 months postoperatively. Anterior angle parameters were determined using swept source optical coherence tomography. We investigated correlations between preoperative angle parameters [angle open distance (AOD); trabecular iris surface area (TISA); angle recess area (ARA); trabecular iris angle (TIA)] and postoperative unpredicted refractive errors. RESULTS In patients with OAG, significant differences were noted between preoperative predicted and postoperative real refractive errors, with more myopia than predicted. No significant differences were recorded in controls. Angle parameters (AOD, ARA, TISA, and TIA) at the superior and inferior quadrant were significantly correlated with differences between predicted and postoperative refractive errors in OAG patients (-0.321 to -0.408, p<0.05). Superior quadrant AOD 500 was significantly correlated with postoperative refractive differences in multivariate linear regression analysis (β=-2.925, R²=0.404). CONCLUSION Clinically unpredicted refractive errors after cataract surgery were more common in OAG than in controls. Certain preoperative angle parameters, especially AOD 500 at the superior quadrant, were significantly correlated with these unpredicted errors.
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Affiliation(s)
- Wonseok Lee
- Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Hyoung Won Bae
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Si Hyung Lee
- Department of Ophthalmology, Eulji University Hospital, Daejeon, Korea
| | - Chan Yun Kim
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Gong Je Seong
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
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Moghimi S, Johari M, Mahmoudi A, Chen R, Mazloumi M, He M, Lin SC. Predictors of intraocular pressure change after phacoemulsification in patients with pseudoexfoliation syndrome. Br J Ophthalmol 2016; 101:283-289. [PMID: 27281754 DOI: 10.1136/bjophthalmol-2016-308601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/21/2016] [Accepted: 05/11/2016] [Indexed: 11/03/2022]
Abstract
AIM To evaluate anterior chamber biometric factors and intraoperative metrics associated with the intraocular pressure (IOP) reduction after phacoemulsification in non-glaucomatous pseudoexfoliative syndrome (PXS) eyes. METHOD Thirty-three patients were enrolled in this prospective interventional study. Images were excluded if they had poor quality, poor perpendicularity or inability to locate sclera spurs. Anterior chamber depth (ACD), anterior chamber area (ACA), iris thickness, iris area, iris curvature, lens vault, angle opening distance (AOD500, AOD750) and trabecular iris space area (TISA500, TISA750) were measured in qualified images using the Zhongshan Angle Assessment Program and compared preoperatively and 3 months postoperatively. Cumulative dissipated energy (CDE), aspiration time and infusion fluid usage during cataract surgery were obtained from the phacoemulsification machine's metrics record. Postoperative IOP change was compared with these anatomical and intraoperative metric parameters. RESULTS Mean IOP was 18.1±3.4 mm Hg preoperatively and decreased by 3.3 mm Hg (18%) to 14.8±3.6 mm Hg at 3 months postoperatively (p<0.001). All angle parameters, ACD and ACA increased significantly postoperatively (p<0.001 for all) and iris curvature decreased (p<0.001). In univariate analysis, preoperative IOP (B=-0.668, p=0.002), infusion fluid usage (B=-0.040, p=0.04) and aspiration time (B=-0.045, p=0.003) were negatively associated with IOP decrease after phacoemulsification. Changes in IOP did not demonstrate significant associations with CDE measurements or anterior segment optical coherence tomography measurements, including preoperative angle, iris or anterior segment parameters. In the final multivariate regression model, preoperative IOP (B=-0.668, p=0.002) and infusion fluid usage (B=-0.041, p=0.04) were significantly associated with IOP drop and together can predict 45.1% (p=0.002) of the variability in IOP change. CONCLUSIONS Non-glaucomatous patients with PXS experience moderate IOP reduction following phacoemulsification, and this effect is correlated with preoperative IOP, aspiration time and infusion fluid used intraoperatively.
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Affiliation(s)
- Sasan Moghimi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Beckman Vision Center, University of California, San Francisco, California, USA
| | | | - Alireza Mahmoudi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Rebecca Chen
- Beckman Vision Center, University of California, San Francisco, California, USA.,Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Mehdi Mazloumi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mingguang He
- Department of Ophthalmology, University of Melbourne, Melbourne, Australia
| | - Shan C Lin
- Beckman Vision Center, University of California, San Francisco, California, USA
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Intraocular Pressure Reduction after Phacoemulsification versus Manual Small-Incision Cataract Surgery: A Randomized Controlled Trial. Ophthalmology 2016; 123:1695-1703. [PMID: 27234929 DOI: 10.1016/j.ophtha.2016.04.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 03/29/2016] [Accepted: 04/06/2016] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To compare reduction in intraocular pressure (IOP) and change in anterior chamber angle configuration between eyes undergoing phacoemulsification versus those undergoing manual small-incision cataract surgery (MSICS). DESIGN Prospective, randomized, double-masked, parallel assignment clinical trial. PARTICIPANTS Five hundred eyes of 500 participants 40 to 70 years of age with normal IOP, gonioscopically open angles, and age-related cataract. METHODS Eyes underwent phacoemulsification or MSICS after a 1:1 randomization and allocation code. Best-corrected vision, IOP, comprehensive slit-lamp evaluation, and anterior segment (AS) optical coherence tomography (OCT) were performed at baseline and at 1, 3, and 6 months follow-up. MAIN OUTCOME MEASURES Change in IOP (ΔIOP) and AS OCT parameters between baseline and 6 months after surgery. RESULTS Six months, similar IOP reduction was observed in eyes undergoing phacoemulsification (ΔIOP = 2.7±2.9 mmHg) and MSICS (ΔIOP = 2.6±2.6 mmHg; P = 0.70). Widening of the angle opening distance (AOD) 500 μm from the scleral spur (median ΔAOD500 = 103 μm; interquartile range = 39-179 μm) was also similar in both groups (P = 0.28). Multivariate linear regression analysis showed that eyes with higher baseline IOP experienced significantly greater reduction in IOP at 6 months (ΔIOP = 0.46-mmHg reduction for every 1-mmHg increment in baseline IOP; 95% confidence interval [CI], 0.4-0.5 mmHg; P < 0.001). After adjusting for covariates, the magnitude of widening of AOD500 was not associated significantly with reduction in IOP (1.33-mmHg reduction for every 1-mm increment in AOD500; P = 0.07). Baseline AOD500 (β = -0.60-mm change/1-mm increment of baseline AOD; 95% CI, -0.67 to -0.53 mm) and anterior chamber depth (β = 0.07-mm change/1-mm increment of baseline anterior chamber depth; 95% CI, 0.04-0.1 mm) were significant predictors of AOD500 widening at 6 months. CONCLUSIONS Both phacoemulsification and MSICS led to significant and similar IOP reductions 6 months after surgery, and both surgeries produced similar changes in anterior chamber and angle parameters. Higher baseline IOP was associated with greater IOP reduction; IOP reduction also can be attributed partly to changes in angle and anterior chamber configuration, although these parameters were unable to predict significantly predict IOP drop at 6 months.
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Schwartz D, Samples J, Korosteleva O. Therapeutic ultrasound for glaucoma: clinical use of a low-frequency low-power ultrasound device for lowering intraocular pressure. J Ther Ultrasound 2014; 2:15. [PMID: 25512870 PMCID: PMC4266006 DOI: 10.1186/2050-5736-2-15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 08/20/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This is a first-in-human study to determine the efficacy and tolerability of a new method of treating glaucoma using a low-power, low-frequency, focused therapeutic ultrasound for glaucoma (TUG) device designed to trigger an inflammatory reaction in the anterior chamber angle and trabecular meshwork to enhance outflow. The use of the device is anticipated for mild or moderate open-angle glaucoma as an enhancement to outflow. METHODS In a two-branch clinical trial, a total of 26 primary open-angle glaucoma patients underwent a procedure consisting of the external application of the TUG device. In branch 1, nine of these patients were naïve to pharmaceutical treatment or had been off of medication for over 6 months. In branch 2, 17 patients were treated after a medication washout period. All patients in the study were followed for 12 months. RESULTS In branch 1, there was a decrease in intraocular pressure averaging over 20% lasting at least a year in 74% of the eyes with non-normotensive open-angle glaucoma. In branch 2, an average of two visits while on medication provided the comparison intraocular pressure (IOP) to the effect of the TUG treatment after washout. It was seen that the intraocular pressure over the year post-treatment was equal to or better than the pharmaceutical control in close to 80% of measurements. CONCLUSION A novel device for lowering intraocular pressure is described with a potential for adding to our armamentarium for treating glaucoma. This is a small cohort study which indicates beneficial trends. TRIAL REGISTRATION NUMBER The study was a registered clinical trial, #ISRCTN50904302.
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Affiliation(s)
- Donald Schwartz
- Long Beach Eye Care Associates, 2650 Elm Avenue #108, Long Beach, CA 90806, USA ; USC Eye Institute, Los Angeles, CA, USA ; UC Irvine Gavin Herbert Eye Institute, Irvine, CA, USA
| | | | - Olga Korosteleva
- Department of Mathematics and Statistics, California State University, Long Beach, CA, USA
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Sharma R, Sharma A, Arora T, Sharma S, Sobti A, Jha B, Chaturvedi N, Dada T. Application of anterior segment optical coherence tomography in glaucoma. Surv Ophthalmol 2013; 59:311-27. [PMID: 24138894 DOI: 10.1016/j.survophthal.2013.06.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 06/24/2013] [Accepted: 06/25/2013] [Indexed: 02/02/2023]
Abstract
Optical coherence tomography (OCT) is a cross-sectional, three-dimensional, high-resolution imaging modality that uses low coherence interferometry to achieve axial resolution in the range of 3-20 μm. Two OCT platforms have been developed: time domain (TD-OCT) and spectral (or Fourier) domain (SD/FD-OCT). Visante anterior segment OCT (Carl Zeiss Meditec) is a TD-OCT widely used for anterior segment imaging. The SD-OCT systems with both posterior and anterior segment imaging capabilities include the RTVue, iVue (Optovue), the Cirrus (Carl Zeiss Meditec), and the Spectralis (Heidelberg Engineering, Inc.). Each of the SD-OCTs has a wavelength in the range of 820-879 nm. Anterior segment OCT is a non-contact method providing high resolution tomographic cross-sectional imaging of anterior segment structures. Anterior segment OCT provides qualitative and quantitative assessment of the anterior segment structures important to the pathogenesis and the anatomical variations of glaucoma, and the approach to and success of treatment. We summarize the clinical applications of anterior segment OCT in glaucoma.
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Affiliation(s)
- Reetika Sharma
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Sharma
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tarun Arora
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sourabh Sharma
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Sobti
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Bhaskar Jha
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Chaturvedi
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tanuj Dada
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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Leffler CT, Giliberti FM, Vasuki V. Cataract extraction and the iris configuration. Ophthalmology 2013; 120:e29-30. [PMID: 23732062 DOI: 10.1016/j.ophtha.2013.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 03/19/2013] [Indexed: 11/17/2022] Open
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Park S, Lee M, Ahn J. Relationship between Preoperative Biometry and Intraocular Pressure Reduction after Phacoemulsification in Normal and Glaucoma Patients. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.1.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Suyoun Park
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
| | - Marvin Lee
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
| | - Jaehong Ahn
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
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Walland MJ, Parikh RS, Thomas R. There is insufficient evidence to recommend lens extraction as a treatment for primary open-angle glaucoma: an evidence-based perspective. Clin Exp Ophthalmol 2011; 40:400-7. [PMID: 21668783 DOI: 10.1111/j.1442-9071.2011.02617.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cataract extraction in primary open-angle glaucoma has not been thought to provide a clinically useful or predictable decrease in IOP. This concept has now been challenged, with the opposite belief being promulgated: namely, that lens exchange should be considered as treatment for glaucoma. This revelation could bring a significant change in the glaucoma treatment paradigm. There are no randomised controlled trials to guide the role of lens extraction in primary open-angle glaucoma. The available evidence suggests at most a modest reduction in IOP from cataract extraction - greater in the presence of pseudoexfoliation - which is likely to be of marginal benefit, and only in milder forms of open-angle glaucoma. There is currently no evidence of any quality to suggest that lens extraction routinely represents a clinically useful treatment for primary open-angle glaucoma.
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Affiliation(s)
- Mark J Walland
- Glaucoma Investigation and Research Unit, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
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