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To compare IOP changes after phacoemulsification in PEX subjects with those in primary open-angle glaucoma (POAG) controls and healthy cataract controls, and to evaluate the factors associated with IOP reduction after phacoemulsification.
This retrospective study included a total of 251 subjects who had undergone cataract surgery; 45 PEX subjects with medically controlled glaucoma (PXG), 40 PEX subjects without glaucoma (PX), age-matched 76 primary open-angle glaucoma (POAG) controls and 90 healthy cataract controls. The IOP changes in the PEX subjects were analyzed and compared with those in the control groups until 3 years after phacoemulsification by linear mixed model after adjusting baseline IOP. An IOP reduction group was determined to be a greater than 20% drop at postoperative 3 years. Logistic regression analysis was used to find factors associated with IOP reduction after phacoemulsification in PEX.
IOP was reduced after phacoemulsification by 17.19% at postoperative 3 years for PEX patients, compared with just 4.41% for POAG and 9.91% for the healthy cataract controls. There were no significant percent-IOP-reduction differences between the PX and PXG patients. According to the subgroup analyses, phacoemulsification resulted in greater IOP reduction for the PXG subjects relative to the POAG control (16.16% vs. 4.41%, P < 0.05). In the univariate and multivariate regression analyses, higher preoperative IOP was found to be a predictor of greater IOP reduction after phacoemulsification. The anterior chamber angle parameters did not demonstrate any significant association with IOP drop.
Phacoemulsification can have an additive IOP-lowering effect in medically controlled PXG for at least 3 years. Greater IOP reduction can be achieved for PEX patients having higher preoperative IOP.