In addition to rectifying a cloudy lens, cataract surgery’s other well-known benefit is a reduction in intraocular pressure (IOP). Patients with mild glaucoma can benefit from even a slight reduction in IOP, which is a good thing because, according to newly published research, a slight reduction is all they’re likely to see. Prior to this, the recent study investigators note that “there is insufficient real-world data in the literature about the role of lens extraction to achieve IOP reduction across all patients with glaucoma,” particularly in cases where the IOP is less than 30mm Hg and the angles are open.1
In a real-world retrospective analysis of clinical data collected across the United Kingdom, the investigators found that eyes without angle closure that underwent phacoemulsification alone experienced only a modest reduction of IOP.
They examined the records of 20,508 eyes without known pathology and 2,251 eyes from patients with glaucoma undergoing cataract lens extraction between January 2006 and May 2015. In the eyes without pathology, the mean reduction in IOP was only 1.40mm Hg. In known glaucomatous eyes, it was 1.03mm Hg.1
The researchers believe this information could bolster the use of minimally invasive glaucoma surgery (MIGS) drainage devices, which are designed to support the IOP lowering effects of phacoemulsification.2
“This data should aid the interpretation of the efficacy of MIGS devices when a cataract surgery alone control cohort is used,” the research team explained in their paper. They feel their results could help researchers create a mathematical formula to predict the final IOP after cataract surgery.
“This would be beneficial to guide clinical decision-making in patients with glaucoma and allow the use of cataract extraction alone to be more realistically considered as a primary IOP lowering intervention.”1
1. Leal I, Chu C, Yang Y, et al. Intraocular pressure reduction after real-world cataract surgery. J Glaucoma. May 1, 2020. [Epub ahead of print].
2. Eliassi-Rad B, Singh V, Aref A, et al. Microinvasive glaucoma surgery (MIGS). Eyewiki. December 11, 2019. Accessed May 15, 2020.