The Effect of Phacoemulsification on Intraocular Pressure in Medically Controlled Open-Angle Glaucoma Patients

PURPOSE: To evaluate intraocular pressure (TOP) after phacoemulsification in patients with medically controlled open-angle glaucoma (OAG), and examine the association of biometric variables to TOP changes. DESIGN: Retrospective case series. METHODS: Open-angle glaucoma patients without prior incisional glaucoma surgery undergoing phacoemulsification by a single surgeon between January 1997 and October 2011 were evaluated. Patient charts were reviewed to obtain demographic information, preoperative glaucoma medications, severity and treatment measures, and preoperative and postoperative TOP. RESULTS: A total of 157 eyes (157 patients) were included in the study. The average preoperative TOP of 16.3 +/- 3.6 mm Hg decreased to 14.5 +/- 3.4 mm Hg at 1 year (P < .001). Sixty eyes (38%) required additional medications or laser for TOP control within the first year postoperatively, or had a higher TOP at postoperative year 1 without medication change. Among eyes without postoperative medication changes (n = 102), higher preoperative TOP (P < .001), older age (P = .006), and deeper anterior chamber depth (P = .015) were associated with lower postoperative TOP. CONCLUSIONS: Phacoemulsification resulted in a small average decrease in TOP in patients with OAG. A sizeable proportion of medically controlled glaucoma patients with open angles undergoing phacoemulsification experienced an increase in TOP or required more aggressive treatment to control TOP postoperatively. (C) 2014 by Elsevier Inc. All rights reserved.