Standalone Phacoemulsification Lowers IOP Significantly
By Lynda Seminara
Selected by Richard K. Parrish II, MD
Journal Highlights
American Journal of Ophthalmology, January 2023
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Rothman et al. analyzed IRIS Registry data to determine the real-world IOP changes produced by standalone phacoemulsification. They compared the data with baseline IOP values for the same eyes and for phakic fellow eyes (controls) that subsequently underwent cataract removal. They found that eyes with and without glaucoma that received the standalone surgery had significantly lower IOP in the 90-day postoperative period relative to baseline and fellow-eye IOP.
This retrospective cohort study included 1,334,868 patients in the IRIS Registry. Of these, 336,060 had glaucoma. All patients received standalone phacoemulsification in one eye, and their fellow eye later underwent cataract surgery. Mean daily IOP values were obtained and compared for surgical and control eyes from post-op day 1 to day 90. A generalized linear model was applied to determine when the postoperative daily mean IOP stabilized, which represented the final mean IOP. This IOP value was compared with baseline IOP.
Shortly after surgery, mean IOP spiked initially. However, by postoperative day 13, the daily mean IOP was significantly lower for surgically treated eyes (p < .001 vs. controls), which persisted through 90 days postoperatively. The mean final IOP of eyes that had surgery was 1.55 mm Hg lower than their baseline value, representing a reduction of 7.79%. After the standalone procedure, final IOP was 1.91 mm Hg lower for glaucomatous eyes (8.89% reduction) and 1.37 mm Hg lower for eyes without glaucoma (7.24% reduction). Regardless of glaucoma status, nearly all eyes treated surgically had a significant IOP decline (p < .0001); the exception was eyes with uveitic glaucoma (p = .0016).
Despite the limitations of retrospective research, this study provides meaningful evidence of the IOP-lowering effect of standalone phacoemulsification, said the authors, which was more pronounced in eyes with glaucoma, ocular hypertension, primary angle closure, and pseudoexfoliation.
The original article can be found here.