Rees Jack P, Khuu Thomas H, Sanchez Facundo G, Gardiner Stuart K, Jones Emily P, Kinast Robert M, Mansberger Steven L
Devers Eye Institute, Legacy Health, Portland, OR.
Elson S. Floyd College of Medicine, Washington State University, Spokane, WA.
J Glaucoma. 2025 Aug 1;34(8):637-643. doi: 10.1097/IJG.0000000000002589. Epub 2025 May 9.
Increasing lens thickness was the anterior segment parameter most associated with IOP spikes in glaucoma patients after cataract surgery.
To determine whether anterior segment anatomy is associated with intraocular pressure spike on postoperative day 1 (POD1) after cataract surgery in participants with glaucoma.
Optical biometry measured multiple eye parameters before cataract surgery in 48 eyes (39 participants) with glaucoma. Preoperative intraocular pressure (IOP) was the mean of 3 visits before cataract surgery and postoperative IOP on day 1 was defined as the IOP on POD1 after cataract surgery. Change in IOP was the difference between postoperative and preoperative IOP. A "5 mm Hg IOP spike" and "10 mm Hg IOP spike" were defined as POD1 IOP ≥ 21 mm Hg with IOP ≥5 or ≥10 mm Hg higher than preoperative IOP, respectively.
Mean POD1 IOP (22.8±8.8 mm Hg) was significantly higher than mean preoperative IOP (15.3±3.6 mm Hg, P <0.001). A 5 mm Hg IOP spike occurred in 45.8% of eyes (22/48 eyes), and 29.2% of eyes (14/48 eyes) had a 10 mm Hg IOP spike. Multivariable analysis showed that increased lens thickness (LT) and axial length (AL) were associated with a 5 mm Hg IOP spike ( P =0.04 and P =0.09, respectively), and increased LT was associated with a 10 mm Hg IOP spike ( P =0.02). When using change in IOP, increased LT and a lower number of preoperative medications were significant predictors of increased IOP after cataract surgery.
IOP spikes were common in glaucoma patients after cataract surgery and were associated with anterior segment anatomy. Future studies may use risk factors to identify and prevent IOP spikes in glaucoma patients after cataract surgery.
晶状体厚度增加是青光眼患者白内障手术后与眼压峰值最相关的眼前节参数。
确定青光眼患者白内障手术后第1天（POD1）的眼压峰值是否与眼前节解剖结构有关。
对48只眼（39名参与者）的青光眼患者在白内障手术前进行光学生物测量，测量多个眼部参数。术前眼压为白内障手术前3次测量的平均值，术后第1天的眼压定义为白内障手术后POD1的眼压。眼压变化为术后眼压与术前眼压之差。“5 mmHg眼压峰值”和“10 mmHg眼压峰值”分别定义为POD1眼压≥21 mmHg且眼压比术前眼压高≥5或≥10 mmHg。
POD1平均眼压（22.8±8.8 mmHg）显著高于术前平均眼压（15.3±3.6 mmHg，P<0.001）。45.8%的眼（22/48只眼）出现5 mmHg眼压峰值，29.2%的眼（14/48只眼）出现10 mmHg眼压峰值。多变量分析显示，晶状体厚度（LT）增加和眼轴长度（AL）增加与5 mmHg眼压峰值相关（分别为P = 0.04和P = 0.09），LT增加与10 mmHg眼压峰值相关（P = 0.02）。当使用眼压变化时，LT增加和术前用药数量较少是白内障手术后眼压升高的显著预测因素。
青光眼患者白内障手术后眼压峰值常见，且与眼前节解剖结构有关。未来的研究可能会利用危险因素来识别和预防青光眼患者白内障手术后的眼压峰值。
