[The effect of phacoemulsification of age-related cataract on intraocular pressure and iridocorneal angle parameters in primary open-angle glaucoma].

UNLABELLED

Cataract phacoemulsification with intraocular lens implantation significantly affects the morphology of the anterior chamber angle (ACA) and contributes to a reduction of intraocular pressure (IOP).

PURPOSE

This study investigates the changes in anterior chamber angle configuration and IOP level before and after cataract surgery in primary open-angle glaucoma (POAG) eyes, and assesses its possible relationship with the axial length of the eye.

MATERIAL AND METHODS

The study included 38 patients with immature senile cataract and compensated unoperated stage I-II POAG. Patients underwent anterior segment optical coherence tomography (AS-OCT) with measurement of the angle opening distance (AOD) and trabecular-iris space area (TISA) before and six weeks after the surgery, as well as axial length and corneal-compensated IOP (IOP).

RESULTS

After the surgery 92.11% of patients showed a decrease in IOP an average of 1.84±1.95 mm Hg (by 12.33±10.21% of the baseline); the maximum decrease in the IOP level was 8.35 mm Hg (by 40.97% of the baseline). AS-OCT data indicates that cataract phacoemulsification causes an increase in anterior chamber angle width: AOD increased from 0.510±0.175 to 0.771±0.156 mm, and TISA increased from 0.266±0.090 to 0.494±0.096 mm. The strongest correlations were found between the axial length, postoperative TISA increase (%TISA) and postoperative IOP reduction (% IOP). Postoperatively, specific changes could be observed in the trabecular meshwork in 28.95% of cases in the form of elongation and strain of the membrane.

CONCLUSIONS

Cataract extraction contributes to a significant reduction in IOP due to anterior chamber angle expansion, trabecular meshwork stretching, and improved aqueous outflow.