Long-Term Intraocular Pressure Change after Clear Corneal Phacoemulsification in Thai Glaucoma Patients
Yupin Leelachaikul MD*, Ataya Euswas MD*
Affiliation : * Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Objectives : To evaluate long-term intraocular pressure (IOP) changes after sutureless clear corneal
phacoemulsification in eyes with preoperatively controlled glaucoma.
Design : Retrospective study.
Setting : Eye clinic, Ramathibodi Hospital, Faculty of Medicine, Mahidol University.
Materials and Methods : The medical records of 218 patients who had uneventful sutureless clear corneal
phacoemulsification with acrylic foldable lens (IOL) implantation were retrospectively reviewed. Included
were 58 patients with medically controlled open-angle glaucoma and 160 normal controls. Follow-up was 12
to 18 months. Outcome measures were postoperative IOP and number of glaucoma medications.
Results : Postoperatively, there was an insignificant decrease in IOP in the glaucoma group; the mean decrease
was 1.4 mm Hg + 3.8 (SD) at 12 months and 1.6 + 4.2 mm Hg at 18months. The mean number of medications
decreased significantly at 12 months (0.51 + 0.75) and at 18 months (0.41 + 0.83) (P = .04). The control group
also had a significant decrease in IOP, with a mean decrease of 0.83 + 2.8 mm Hg at 12 months (P = .01) and
1.26 + 2.9 mm Hg at 18 months (P < .0001). The decrease in IOP was more pronounced in eyes with a higher
preoperative IOP in both the glaucoma and control groups.
Conclusion : These findings suggest that sutureless clear corneal phacoemulsification with foldable acrylic
IOL implantation is a relatively safe and simple surgical option in patients with cataract and well-controlled
glaucoma. The approach provided favorable long-term IOP change and led to rapid visual rehabilitation in
both the glaucoma and control group.
Keywords : Intraocular pressure, Phacoemulsification, Glaucoma
