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  • Standalone Phacoemulsification Lowers IOP Significantly

    By Lynda Seminara
    Selected by Richard K. Parrish II, MD
    Cataract/Anterior Segment
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    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.