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DOI: 10.1055/s-2003-812552
Intraocular Pressure after Phacoemulsification with Posterior Chamber Lens Implantation in Open-Angle Glaucoma
Intraokulardruck nach Phakoemulsifikation mit Hinterkammerlinsenimplantation bei OffenwinkelglaukomPublication History
Eingegangen: 5. Mai 2003
Angenommen: 13. August 2003
Publication Date:
05 January 2004 (online)
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Zusammenfassung
Hintergrund: Zur Evaluation der Intraokulardruck(IOP)-Änderungen nach Phakoemulsifikation (Phako) bei Hinterkammerlinsenimplantation (PC-IOL) in Augen mit primär-chronischem Offenwinkelglaukom (POAG) mindestens zwei Jahre nach Operation. Patienten und Methoden: In dieser retrospektiven Studie waren 19 Augen von 13 POAG-Patienten mit regulärer Clear-cornea-Phako mit Hinterkammerlinsenimplantation und einem postoperativen Nachuntersuchungszeitraum von mindestens zwei Jahren eingeschlossen. Kein Patient hatte vorhergehende intraokulare Eingriffe oder eine Argonlasertrabekuloplastik. Ergebnisse: Der durchschnittliche präoperative IOP lag bei 16,9 ± 2 mm Hg. Der durchschnittliche Nachbeobachtungszeitraum lag bei 36 ± 11,8 Monaten. In der ersten postoperativen Woche zeigte sich ein signifikanter Abfall des durchschnittlichen IOP (13,8 ± 3,0 mm Hg; p = 0,000). Nach 1 und 4 Monaten postoperativ war der IOP weiterhin signifikant geringer als präoperativ. 8 Monate postoperativ zeigte der IOP einen signifikanten Anstieg auf 15,9 ± 2,9 mm Hg (p = 0,022) im Hinblick auf die erste postoperative Woche, mit einem erneuten signifikanten Abfall auf 15,5 ± 2,6 mm Hg (p = 0,020) nach 1 Jahr postoperativ und annähernd auch im 2. und 3. postoperativen Jahr. Nach 4 Jahren lag der durchschnittliche IOP bei 15,0 ± 3,1 mm Hg (p = 0,216), wobei die statistische Nichtsignifikanz auf die zu geringe Patientenanzahl zurückgeführt wird. In 79 % (15 Augen) unserer Fälle blieb die antiglaukomatöse Therapie unverändert, in 21 % (4 Augen) war die Therapie reduziert. Schlussfolgerungen: Eine komplikationslose Phakoemulsifikation mit Hinterkammerlinsenimplantation in gut kontrollierten primär-chronischen Offenwinkelglaukomaugen war assoziiert mit einem statistisch signifikanten langfristigen Abfall des Introkulardrucks, die postoperative antiglaukomatöse Medikation konnte in mehr als 20 % der Augen reduziert werden.
Abstract
Background: To evaluate changes in intraocular pressure (IOP) after phacoemulsification (Phaco) with posterior chamber lens (PC IOL) implantation in eyes with primary open-angle glaucoma (POAG) at least 2 years after surgery. Patients and methods: 19 eyes of 13 POAG patients who underwent uneventful clear cornea Phaco with PC IOL implantation and with follow-up of at least 2 years after surgery were included in this retrospective study. None of them had previous intraocular surgery or argon laser trabeculoplasty. Results: The average preoperative IOP was 16.9 ± 2.02 mm Hg. The average follow-up of was 36 ± 11.8 months. 1 week after surgery a significant decrease in average IOP was observed (13.8 ± 3.0 mm Hg; P = 0.000). 1 and 4 months after surgery IOP was still significantly lower than preoperatively. 8 months after surgery IOP significantly increased to 15.9 mm Hg (± 2.9 mm Hg; P = 0.022) with respect to 1 week postoperatively, but then again significantly decreased to 15.5 mm Hg (± 2.6 mm Hg; P = 0.020) 1 year after surgery and stayed approximately the same at 2 and 3 years after surgery. After 4 years the average IOP was 15.0 mm Hg (± 3.1 mm Hg; P = 0.216), that was statistically insignificant because of the small number of patients. In 79 % (15 eyes) of our cases medical antiglaucoma treatment was unchanged, in 21 % (4 eyes) the therapy was reduced. Conclusions: Uneventful Phaco with PC IOL implantation in good medically controlled POAG eyes was associated with a statistically significant long-term decrease in IOP, allowing the reduction of postoperative antiglaucoma medications in more than 20 % of the eyes.
Schlüsselwörter
Primär-chronisches Offenwinkelglaukom - Intraokulardruck - Phakoemulsifiaktion - Intraokularlinse
Key words
Primary open - angle glaucoma - intraocular pressure - phacoemulsification - intraocular lens
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Dr. Mojca Hudovernik
Dept. of Ophthalmologie · Teaching Hospital Maribor
Ljubljanska 5
2000 Maribor · Slovenia