Researchers in California have found that patients with primary open-angle glaucoma (POAG) or narrow angles/chronic angle-closure were more likely to maintain an IOP reduction after cataract surgery—and the higher the baseline IOP, the higher the odds of achieving an IOP reduction.
Their study assessed the EHR data of 4,883 patients (7,574 eyes) who underwent cataract surgery with a median follow-up of 244 days. The researchers kept note of sustained post-op IOP reduction, measured at 14 months or last follow-up, while using equal or fewer glaucoma medications compared with baseline and without additional IOP-lowering intervention on the operative eye. The mean pre-op baseline IOP for all patients was 15.2mm Hg, which decreased to 14.2mm Hg at 12 months post-op. Patients with IOP ≥21.0mm Hg had a mean postoperative IOP reduction ranging from -6.2mm Hg to -6.9mm Hg.
Cataract surgery was more likely to yield sustained IOP reduction for patients with POAG or narrow angles/angle-closure compared with patients without glaucoma. The researchers noted that patients with a higher baseline IOP were more likely to achieve sustained post-op IOP reduction (hazard ratio = 1.06 per 1.0mm Hg increase in baseline IOP).
The study concluded that extracting outcomes from EHR data is a potentially useful method for answering key clinical questions on a large scale.
|Wang SY, Azad AD, Lin SC, et al. Intraocular pressure changes after cataract surgery in patients with and without glaucoma: an informatics-based approach. Ophthalmol Glaucoma. June 9, 2020. [Epub ahead of print].