J Korean Ophthalmol Soc > Volume 59(10); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(10):930-937.
DOI: https://doi.org/10.3341/jkos.2018.59.10.930    Published online October 15, 2018.
The Effect of Intraoperative Factors on Intraocular Pressure Reduction after Phacoemulsification in Open-angle Glaucoma.
Yuli Park, Jung Il Moon, Kyong Jin Cho
1Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea. perfectcure@hanmail.net
2Department of Ophthalmology, Yeouido St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
개방각녹내장 환자에서 수정체유화술 시 안압하강에 영향을 미치는 인자 분석
단국대학교 의과대학 단국대학교병원 안과학교실1, 가톨릭대학교 의과대학 여의도성모병원 안과학교실2
Correspondence:  Kyong Jin Cho,
Email: perfectcure@hanmail.net
Received: 26 April 2018   • Revised: 4 July 2018   • Accepted: 28 September 2018
To identify independent predictors of long-term postoperative intraocular pressure (IOP) reduction after phacoemulsification in patients with primary open-angle glaucoma (POAG). METHODS: This was a retrospective review of 145 eyes with open-angle glaucoma (OAG) who were followed up for more than 3 years after uncomplicated phacoemulsification cataract surgeries. Demographic, clinical, biometric, and intraoperative variables such as IOP, refractive errors, anterior chamber depth, axial length, relative lens position (RLP), and phacoemulsification parameters such as phaco time, cumulative dissipated energy (CDE), and balanced salt solution volume were evaluated at 6, 12, 24, and 36 months after surgery. Univariate and multivariate linear regression were used to analyze the relationship between these variables and the postoperative IOP. RESULTS: There was a statistically significant average postoperative IOP reduction at 6, 12, 24, and 36 months of −1.9 ± 2.9, −1.6 ± 2.8, −1.4 ± 3.1, and −1.2 ± 2.7 mmHg, respectively (p < 0.01). Higher preoperative IOP (p < 0.001), a more relative anterior lens position (p < 0.001), shorter phaco time (p < 0.05), and higher CDE (p < 0.05) were significantly associated with a greater postoperative decrease in IOP using univariate analyses. Using multivariate analyses, preoperative IOP (p < 0.01), lens position (p = 0.04), and phaco time (p = 0.04) were associated with greater postoperative IOP reduction at 3 years. CONCLUSIONS: Higher preoperative IOP was associated with a greater IOP-lowering effect after phacoemulsification in OAG patients. Phaco time and anterior RLP were independently associated with IOP reduction after adjusting for age and preoperative IOP. These findings have important implications when considering combined cataract extraction and filtration surgery for POAG patients.
Key Words: Cataract;Intraocular pressure;Open-angle glaucoma;Phacoemulsification

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