EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/387844
107 EW RESIDENTS October 2014 16.5% compared to preop measure- ments was found in OHTS patients who underwent cataract surgery where 39.7% of patients achieved at least 20% reduction in IOP com- pared to preoperative values. As a report from a single center, the data from Brown et al. has the advantage over the OHTS patient data by controlling for variability in cataract surgeons and surgery techniques. Brown et al.'s study serves as an important investigation from which prospective studies or retrospective reviews of clinical trial patients with similar characteristics can be designed. The use of clinical trial data sets or the use of prospec- tive study design would allow future investigations to better define study methodology. For example, IOP measurement as defined by OHTS or the World Glaucoma Associ- ation would help to standardize IOP measurement both pre- and postoperatively. 7,8 Also, follow-up See more patients in the same amount of time without increasing staff. Varitronics, the leader in Non-Verbal Interoffice Communications for over four decades, offers the most feature-rich systems on the market today. Our custom designed Call Systems will streamline the way you work so that you can decrease your patient's waiting time while increasing your staff's efficiency. Call, email, or visit our web site today to see how easy it is to benefit from the efficiency of Varitronics' Call System. 800.345.1244 email:varimed@varitronics.com www.varitronics.com Increase patient flow and overall practice efficiency. Increase profits. Varitronics can show you how! of Var Inte fou sys des the d Call Systems are available for both new and existing construction. Leading the way in Interoffice Communications Wa l l p a n e l a n d p a g e r C S 2 0 0 0 W i r e l e s s S y s t e m SEE US AT ASCRS AT BOOTH 122 C M Y CM MY CY CMY K Cataract surgery reduces intraocular pressure in patients with narrow angles and chronic angle closure glaucoma Reay H. Brown, MD, Le Zhong, BS, Allison L. Whitman, Mary G. Lynch, MD, Patrick D. Kilgo, MS, and Kristen L. Hovis J Cataract Refract Surg (Oct.) 2014;40:1610–1614 Purpose: To investigate the effect of cataract surgery on intraocular pressure (IOP) in patients with narrow angles and chronic angle closure glaucoma and to determine whether the change in IOP was correlated with the preoperative pressure, axial length (AL), and anterior chamber depth (ACD). Setting: Private practice, Atlanta Design: A single-center, retrospective case study of 83 eyes from 56 patients Methods: Charts were reviewed from patients with narrow angles or chronic angle closure glaucoma that had undergone cataract surgery. All eyes previously had undergone laser iridotomy. Data recorded included pre- and postoperative IOP, AL, and ACD. The preoperative IOP was used to stratify eyes into four groups. Results: The mean reduction in pressure was 3.28 mmHg (18%) for all eyes with 88% experiencing a decrease in pressure. There was a significant correlation (r=0.68, P<0.001) between preoperative pressure and the magnitude of IOP reduction. The mean decrease in IOP was 5.3 mmHg in eyes with preoperative pressure above 20 mmHg, 4.6 mmHg in the >18 to 20 mmHg group, 2.5 mmHg in the >15 to 18 mmHg group, and 1.4 mmHg for eyes with pressures of 15 mmHg or less. Average follow-up was 3.0±2.3 years. Conclusion: Cataract surgery reduces pressure in patients with narrow angles and chronic angle-closure glaucoma. The magnitude of reduction is highly correlated with preoperative IOP and weakly correlated with ACD. continued on page 108 interval would be better controlled if clinical trial data sets or prospective studies are done and would enable the study to better determine the sustainability of IOP-lowering by cataract surgery in narrow angle and CACG patients. Although patient numbers may not have been large enough in this study, it would have been interest- ing for Brown et al. to stratify their results based on whether patients had CACG or narrow angles and to determine whether there were differ- ences in how the 2 different patient groups behaved after surgery. It is unclear from their report whether patients with "narrow angles" were primary angle closure suspects or if they had primary angle closure. The methods section does not describe whether or not gonioscopy was conducted. Might it therefore be possible that one of these groups See Us At AAO at Booth 1739