Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Department of Ophthalmology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
J Korean Med Sci. 2019 Jan 30;34(6):e47. doi: 10.3346/jkms.2019.34.e47. eCollection 2019 Feb 18.
We investigated how cataract surgery might influence long-term intraocular pressure (IOP) change in both healthy subjects and glaucoma patients.
A retrospective analysis of patients who had had clear corneal phacoemulsification with a minimum of 12 months of follow up was performed. Glaucoma patients with medically controlled open-angle glaucoma and healthy subjects with no glaucoma were included in the analysis. The change of IOP after phacoemulsification and factors associated with postoperative IOP change were investigated.
In total, 754 eyes of 754 patients, specifically 106 patients with glaucoma and 648 patients with no glaucoma (i.e., healthy subjects) were enrolled. The phacoemulsification effected a reduction of IOP: 1.03 ± 3.72 mmHg in healthy subjects and 1.08 ± 3.79 mmHg in glaucoma patients at postoperative 1 year ( = 0.656). There were negative coefficients of IOP until 1 year of follow up (all < 0.001), but the IOP change gradually showed a less steeply decreasing slope (correlation coefficient: -0.993), compared with those for 1 week and 1 month of follow up (correlation coefficients: -1.893 and -1.540, respectively). In the multivariate analysis, age and preoperative IOP showed significant associations with postoperative IOP change (regression coefficients: -0.034 and 0.419 respectively, all < 0.001).
Phacoemulsification resulted in IOP reduction, which effect regressed in healthy subjects and glaucoma patients over the course of long-term follow up. Therefore, long-term monitoring of IOP change is needed. In cases of higher preoperative IOP and young patients, phacoemulsification alone is a reliable option for IOP control.
我们研究了白内障手术对健康受试者和青光眼患者的长期眼压（IOP）变化的影响。
对至少随访 12 个月的行透明角膜超声乳化白内障吸除术的患者进行回顾性分析。纳入分析的患者包括经药物治疗控制的开角型青光眼患者和无青光眼的健康受试者。研究了超声乳化白内障吸除术后 IOP 的变化及与术后 IOP 变化相关的因素。
共纳入 754 只眼（754 例患者），其中 106 例为青光眼患者，648 例为无青光眼（即健康受试者）。超声乳化白内障吸除术后，健康受试者和青光眼患者的 IOP 分别降低 1.03 ± 3.72mmHg 和 1.08 ± 3.79mmHg（ = 0.656）。IOP 在术后 1 年呈负系数变化（均 ＜ 0.001），但与术后 1 周和 1 个月相比，IOP 变化的斜率逐渐变缓（相关系数：-0.993；-1.893 和-1.540）。多变量分析显示，年龄和术前 IOP 与术后 IOP 变化显著相关（回归系数分别为-0.034 和 0.419，均 ＜ 0.001）。
超声乳化白内障吸除术后 IOP 降低，在健康受试者和青光眼患者中，这种效应在长期随访过程中逐渐减弱。因此，需要长期监测 IOP 变化。对于术前 IOP 较高和年轻患者，单纯超声乳化白内障吸除术是一种可靠的眼压控制方法。
