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J Cataract Refract Surg. 2012 Jan;38(1):117-23. doi: 10.1016/j.jcrs.2011.07.033. Epub 2011 Nov 13.

Preoperative iris configuration and intraocular pressure after cataract surgery.

Author information

1
Ophthalmology Section, Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, Virginia, USA.

Abstract

PURPOSE:

To determine predictors of long-term intraocular pressure (IOP) after cataract surgery.

SETTING:

Hunter Holmes McGuire Veterans Administration Hospital, Richmond, Virginia, USA.

DESIGN:

Case series.

METHODS:

Clinical variables, IOP by applanation tonometry, anatomic features on anterior segment optical coherence tomography (AS-OCT), and gonioscopy were assessed before and after uneventful cataract surgery in eyes with open filtration angles. Multivariate linear regression of preoperative measurements was used to predict the mean IOP from 2 to 18 months postoperatively.

RESULTS:

The study enrolled 77 eyes (77 patients). Prediction of the mean postoperative IOP improved when up to 4 preoperative IOP values were averaged (r(2) = 0.20) compared with using the final preoperative IOP value only (r(2) = 0.13). The mean iris cross-sectional area decreased after surgery, from 3.84 mm(2) to 3.70 mm(2) (P=.01). The mean convex hull of the iris segments also decreased, from 5.05 mm(2) to 4.19 mm(2) (P<.001). The mean postoperative IOP was independently predicted by the preoperative average IOP, primary open-angle glaucoma, and the convex hull of cross-sectional iris segments (P=.001, model r(2) = 0.38) or iris cross-sectional area (P=.003, model r(2) = 0.36). Phacoemulsification parameters, incision type, and anterior chamber angle and depth did not predict postoperative IOP.

CONCLUSIONS:

Averaging up to 4 preoperative IOP values improved postoperative IOP predictions. A high iris cross-sectional area or convex hull of the iris segments on AS-OCT was associated with lower postoperative IOP. These findings might help identify patients who are likely to have the largest IOP drop after cataract surgery.

PMID:
22082750
DOI:
10.1016/j.jcrs.2011.07.033
[Indexed for MEDLINE]

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