Guan Huan, Mick Andrew, Porco Travis, Dolan Bernard J
Department of Veteran Affairs Medical Center Miami, Miami, Florida 33125, USA.
Optom Vis Sci. 2013 Feb;90(2):179-84. doi: 10.1097/OPX.0b013e31827ce224.
To identify preoperative factors associated with postoperative intraocular pressure (IOP) reduction after phacoemulsification cataract extraction in patients with primary open-angle glaucoma (POAG) treated at a Veterans Affairs Medical Center.
Examination records of 103 eyes of 75 patients with POAG who underwent uncomplicated phacoemulsification cataract extraction were reviewed. Preoperative data collected for analysis included IOP, number of glaucoma medications, spherical equivalent refractive errors, central corneal thickness, anterior chamber depth, and axial length. The IOPs measured 3 to 6 months after surgery were used to calculate the change in IOP after cataract extraction. Statistical analysis was performed to identify preoperative factors associated with postoperative IOP reduction.
The mean postoperative IOP reduction was 1.8 ± 3.5 mm Hg (p < 0.001). Seventy-four percent of eyes (76 of 103) had decreased IOP after cataract surgery. Eight percent of eyes (8 of 103) had no change in IOP. Eighteen percent of eyes (19 of 103) had increased IOP after cataract surgery. The mean preoperative IOPs for eyes with increased, same, and decreased postoperative IOPs were 12 ± 2.2 mm Hg, 14.0 ± 2.3 mm Hg, and 16.4 ± 3.1 mm Hg, respectively. The mean postoperative IOPs change for eyes with increased and decreased postoperative IOPs were +2.7 ± 2.1 mm Hg and -3.7 ± 2.5 mm Hg, respectively. Preoperative IOP was the only preoperative factor significantly associated with postoperative IOP reduction (p < 0.001).
Preoperative IOP was the only factor significantly associated with postoperative IOP reduction after cataract surgery in POAG patients. A higher preoperative IOP was strongly associated with a greater postoperative IOP reduction. Patients with low preoperative IOPs tended to have minimal reduction or even a mild increase in postoperative IOPs. These findings have important implications when considering combined cataract extraction and filtration surgery for POAG patients.
确定在退伍军人事务医疗中心接受治疗的原发性开角型青光眼（POAG）患者行白内障超声乳化吸除术后眼压（IOP）降低的术前相关因素。
回顾了75例接受无并发症白内障超声乳化吸除术的POAG患者的103只眼的检查记录。收集用于分析的术前数据包括眼压、青光眼药物数量、等效球镜屈光不正、中央角膜厚度、前房深度和眼轴长度。术后3至6个月测量的眼压用于计算白内障摘除术后眼压的变化。进行统计分析以确定与术后眼压降低相关的术前因素。
术后平均眼压降低1.8±3.5 mmHg（p<0.001）。74%的眼（103只眼中的76只）白内障手术后眼压降低。8%的眼（103只眼中的8只）眼压无变化。18%的眼（103只眼中的19只）白内障手术后眼压升高。术后眼压升高、不变和降低的眼术前平均眼压分别为12±2.2 mmHg、14.0±2.3 mmHg和16.4±3.1 mmHg。术后眼压升高和降低的眼术后平均眼压变化分别为+2.7±2.1 mmHg和-3.7±2.5 mmHg。术前眼压是与术后眼压降低显著相关的唯一术前因素（p<0.001）。
术前眼压是POAG患者白内障手术后与术后眼压降低显著相关的唯一因素。术前眼压越高，术后眼压降低幅度越大。术前眼压低的患者术后眼压降低往往最小，甚至有轻度升高。在考虑为POAG患者联合进行白内障摘除和滤过手术时，这些发现具有重要意义。
