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Intraocular pressure following phacoemulsification in patients with and without exfoliation syndrome: a 2 year prospective study
  1. K F Damji1,
  2. A G P Konstas2,
  3. J M Liebmann3,
  4. W G Hodge1,
  5. N G Ziakas2,
  6. S Giannikakis2,
  7. G Mintsioulis1,
  8. A Merkur1,
  9. Y Pan1,
  10. R Ritch3,4
  1. 1Department of Ophthalmology, University of Ottawa, Ottawa Hospital Eye Institute, Ottawa, Canada
  2. 2Glaucoma Unit, A University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
  3. 3New York Eye and Ear Infirmary, New York, NY, USA
  4. 4The New York Medical College, Valhalla, NY, USA
  1. Correspondence to: Karim F Damji MD, FRCSC; University of Ottawa Eye Institute, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6; kdamji{at}ohri.ca

Abstract

Aim: To determine the long term intraocular pressure (IOP) response to phacoemulsification in patients with and without exfoliation syndrome (XFS).

Methods: Prospective, multicentre, cohort study with the following inclusion criteria: age over 50 years, open iridocorneal angle, and cataract. Two groups were enrolled: those with XFS and those without. The main outcome was mean IOP reduction 2 years after phacoemulsification cataract extraction (PCE). Univariate and multivariate analyses were performed.

Results: 183 patients were enrolled, 71 with and 112 without XFS. There were 29 patients with glaucoma in both groups. Mean baseline IOP was higher in XFS compared to control eyes (17.60 (SD 3.23) mm Hg v 16.08 (3.18) mm Hg, p = 0.002). Overall IOP reduction was significantly greater in the XFS group at the 2 year time point (−1.85 mm Hg v −0.62 mm Hg in the controls (p = 0.0037)). Multivariate analysis demonstrated that the IOP lowering effect in the XFS group may be related to irrigation volume at the time of surgery. In the subgroup analyses IOP lowering was significantly greater in the XFS and XFG patients than in controls without glaucoma, and POAG controls, respectively. The percentage of patients with a postoperative IOP spike was similar and relatively high in both XFS and control groups (34% v 25%; p = 0.54).

Conclusion: IOP decreases more in patients with XFS following PCE compared to control eyes without XFS. This effect is more pronounced in glaucoma patients and persists for at least 2 years.

  • BCVA, best corrected visual acuity
  • IOP, intraocular pressure
  • PCE, phacoemulsification cataract extraction
  • POAG, primary open angle glaucoma
  • XFG, exfoliative glaucoma
  • XFS, exfoliation syndrome
  • exfoliation syndrome
  • open angle glaucoma
  • cataract
  • intraocular pressure
  • BCVA, best corrected visual acuity
  • IOP, intraocular pressure
  • PCE, phacoemulsification cataract extraction
  • POAG, primary open angle glaucoma
  • XFG, exfoliative glaucoma
  • XFS, exfoliation syndrome
  • exfoliation syndrome
  • open angle glaucoma
  • cataract
  • intraocular pressure

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Footnotes

  • Supported in part by the Joseph Cohen Research Fund of the New York Glaucoma Research Institute, New York, USA.

    No financial interest.

  • Presented in part at the annual meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, FL, USA, April 2004.

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