J Korean Ophthalmol Soc > Volume 60(5); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(5):463-469.
DOI: https://doi.org/10.3341/jkos.2019.60.5.463    Published online May 15, 2019.
Effect of Preoperative Factors and Gonioscopy on Intraocular Pressure Reduction after Phacoemulsification in Glaucoma.
Yuli Park, Young Bin Kim, Kyong Jin Cho
Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea. perfectcure@hanmail.net
녹내장환자에서 백내장수술 후 안압하강에 영향을 미치는 전방각경 점수 및 술 전 인자
박율리⋅김영빈⋅조경진
단국대학교 의과대학 안과학교실
Correspondence:  Kyong Jin Cho,
Email: perfectcure@hanmail.net
Received: 25 October 2018   • Revised: 23 December 2018   • Accepted: 25 April 2019
Abstract
PURPOSE
To evaluate a new gonioscopy score and preoperative factors as a potential predictor for intraocular pressure (IOP) reduction after phacoemulsification. METHODS: This is a retrospective review of 182 eyes with glaucoma of either open or narrow angles that underwent phacoemulsification. Preoperative variables such as age, IOP, refractive errors, anterior chamber depth (ACD), axial length, and lens position were evaluated at 6 months after surgery. A preoperative gonioscopy score was created, summing the Shaffer gonioscopy grading in 4 quadrants. To determine variables associated with IOP change at 6 months, univariate and multivariate linear regression analysis was performed. RESULTS: The mean age of the patients was 72.8 ± 9.5 years and the average preoperative IOP was 16.4 ± 3.7 mmHg with 1.2 glaucoma medications. The mean IOP reduction after phacoemulsification was 2.7 ± 2.2 mmHg at postoperative 6 months. Preoperative IOP (β = 0.55, p < 0.001), gonioscopy score (β = −0.29, p < 0.001), ACD (β = −0.67, p = 0.02), and IOP/ACD ratio (β = 0.58, p = 0.01) were associated with IOP reduction at 6 months. CONCLUSIONS: Preoperative predictors for IOP reduction after phacoemulsification were preoperative IOP, ACD, gonioscopy score, and IOP/ACD ratio in patients with glaucoma. The IOP/ACD ratio and gonioscopy score can be easy parameters to obtain and may help clinicians to estimate the IOP reduction after phacoemulsification.
Key Words: Glaucoma;Gonioscopy;Intraocular pressure;Phacoemulsification


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