Phacoemulsification And Prevention Of Pseudoexfoliative Glaucoma

Published 2023 - 41st Congress of the ESCRS

Reference: PO0837 | Type: Free paper | DOI: 10.82333/1xyq-qx31

Authors: Volodymyr Melnyk* ¹

¹Society of Ukrainian Ophthalmic Surgeons,Kyiv,Ukraine

Purpose

One of the most widespread type of open-angle glaucoma is Pseudoexfoliative glaucoma. It develops in 20-25% patients with Pseudoexfoliative syndrome (PEX). PEX in mostly cases is determined on both eyes, but glaucoma develops usually on one eye, then, in some time, on another eye. Decompensated IOP, advanced stage of glaucoma and cataract are the reasons of combined cataract and glaucoma surgery with high risk of intraoperative and early postoperative complications. Phacoemulsification usually decreases of IOP in cataract patients on 2-3mmHg.

Setting

To assess prophylactic possibility of phacoemulsification on glaucoma development in patients with Pseudoexfoliative syndrome.

Methods

There were determined group of patients - 124 persons (248 eyes). All these people had proved Pseudoexfoliative glaucoma on one eye and only Pseudoexfoliative syndrome (no significant data of glaucoma) and cataract on another eye. All patients were operated by one surgeon - combined cataract and glaucoma surgical procedure on glaucoma eye, and only phacoemulsification (cataract surgery) on the no-glaucoma eye. There were no any complications in intraoperative and postoperative periods.

All patients were controlled during 3 years after surgery. We examined their glaucoma parameters (Visual field and OCT of optic nerve) and Intraocular pressure.

Results

During 3-years of examination there were no determined glaucoma development on no-glaucoma eyes: visual field was stable, OCT showed stability of anatomical parameters of optic nerve.

Dynamic of intraocular pressure showed short-term of increase of IOP during the first month after surgery on 5-10%. In one month after surgery, we fixed decrease of IOP on 10-15% in comparison with preoperative results. IOP was stable during 3-years of observation. There were no one case of prescription of hypotensive drops in one month after surgery.

Conclusions

Cataract surgery (phacoemulsification) allows to decrease intraocular pressure and stabilize visual functions in patients with PEX without significant glaucoma during three-years period after surgery. Also, we can suggest, that cataract surgery is an effective and low-risk method to avoid PEX-glaucoma development.