Xirou Vasiliki, Xirou Tina, Siganos Charalambos, Ntonti Panagiota, Georgakopoulos Constantinos, Stavrakas Panagiotis, Makri Olga E, Kanakis Menelaos, Tsapardoni Foteini, Fragkoulis Ioannis, Garnavou-Xirou Christina, Kozobolis Vassilios
Ophthalmology Department, Hellenic Red Cross Hospital of Athens, Athens, Greece.
Ophthalmology Department, University Hospital of Heraklion, Heraklion, Greece.
Clin Ophthalmol. 2023 Apr 5;17:1047-1055. doi: 10.2147/OPTH.S402550. eCollection 2023.
The aim of this study was to evaluate and compare the changes in Intraocular Pressure (IOP) and other ocular parameters: the Anterior Chamber Angle (ACA), Anterior Chamber Volume (ACV), and Anterior Chamber Depth (ACD) during phacoemulsification surgery in Greek patients with normotensive eyes and those with well-controlled Open-Angle Glaucoma (OAG). Additionally, parameters such as the Corneal Thickness (CCT), Axial Length (AL), Central Macular Thickness (CMT), and Retinal Nerve Fibre Layer (RNFL) were also examined.
This was a prospective observational case-control study that included 50 phakic eyes, 25 normotensive (Group 1), and 25 with OAG: 15 Primary Open-Angle Glaucoma (POAG) and 10 Exfoliation Glaucoma (EXG) (Group 2). Ophthalmic assessment included IOP measurements, ocular biometry, and anterior and posterior segment optical coherence tomography evaluation of the aforementioned ocular parameters, prior and 6 months after phacoemulsification surgery.
At the 6 months post-operative review, a greater IOP reduction was recorded in eyes with OAG, in comparison to normotensive ones (5.3mmHg and 1.6 mmHg respectively). In addition, a significant but similar increase was recorded in the values of the ACA, ACV, and ACD of both groups between the pre- and the post-op period. Furthermore, the CCT and AL values remained unaltered. Finally, there was a non-statistically significant change in the mean CMT and the mean average RNFL of both groups.
Eyes with OAG tend to undergo a greater reduction in IOP post-phacoemulsification surgery, in comparison to normotensive eyes. This reduction may not be solely attributed to ocular anatomical changes after phacoemulsification surgery but may also be due to the remodeling of the trabecular meshwork and the ciliary body. This may be especially true in the case of OAG eyes, which already start off with a compromised trabecular endothelium prior to surgery.
本研究旨在评估和比较希腊正常眼压患者以及病情得到良好控制的开角型青光眼（OAG）患者在白内障超声乳化手术过程中眼压（IOP）及其他眼部参数的变化：前房角（ACA）、前房容积（ACV）和前房深度（ACD）。此外，还检查了诸如角膜厚度（CCT）、眼轴长度（AL）、中心黄斑厚度（CMT）和视网膜神经纤维层（RNFL）等参数。
这是一项前瞻性观察性病例对照研究，纳入了50只晶状体眼，其中25只眼压正常（第1组），25只患有OAG：15只原发性开角型青光眼（POAG）和10只剥脱性青光眼（EXG）（第2组）。眼科评估包括眼压测量、眼部生物测量，以及在白内障超声乳化手术前和术后6个月对上述眼部参数进行眼前段和眼后段光学相干断层扫描评估。
在术后6个月的复查中，与正常眼压患者相比，OAG患者的眼压降低幅度更大（分别为5.3mmHg和1.6mmHg）。此外，两组术前和术后期间的ACA、ACV和ACD值均出现了显著但相似的增加。此外，CCT和AL值保持不变。最后，两组的平均CMT和平均RNFL均未发生具有统计学意义的变化。
与正常眼压患者相比，OAG患者在白内障超声乳化手术后眼压降低幅度更大。这种降低可能不仅仅归因于白内障超声乳化手术后的眼部解剖结构变化，还可能是由于小梁网和睫状体的重塑。对于术前小梁内皮已经受损的OAG患者来说尤其如此。
