Glaucoma Increases Cataract Surgery Complications

by U.S. Medicine

April 7, 2016

JAMAICA PLAINS, MA — A new VA study compared visual acuity outcomes, vision-related quality of life and complications related to cataract surgery in eyes with and without glaucoma.

The retrospective cohort study was published recently in the American Journal of Ophthalmology.1

Using cataract surgery outcomes, the VA Ophthalmic Surgical Outcomes Data Project, a study team led by the VA Boston Healthcare System researchers identified 608 glaucoma cases and 4,306 controls undergoing planned cataract surgery alone.

After adjusting for age, pseudo-exfoliation, small pupil, prior ocular surgery and anterior chamber depth, the investigation found that glaucoma cases were more likely to have posterior capsular tear with vitrectomy, odds ratio 1.8, and sulcus intraocular lens placement, OR 1.65, during cataract surgery.

Results indicate that glaucoma cases were more likely to have postoperative inflammation, OR 1.73; prolonged elevated intraocular pressure, OR 2.96; and additional surgery within 30 days, OR 1.92.

In both groups, mean best-corrected visual acuity (BCVA) and Visual Function Questionnaire (VFQ) scores significantly improved after cataract surgery. Larger improvements in BCVA and VFQ composite scores occurred in the non-glaucoma vs the glaucoma group, however.

The study notes that 3621 non-glaucoma cases, 94.1%, had postoperative BCVA 20/40 or better, compared to 466 glaucoma cases, 89.6%.

“Eyes with glaucoma are at increased risk for complications and have more modest visual outcomes after cataract surgery compared to eyes without glaucoma,” the study authors wrote. “Despite this, glaucoma patients still experience significant improvement in vision-related outcomes after cataract extraction. Further study is needed to explore potential factors that influence cataract surgery outcomes in glaucomatous eyes.”

1 Turalba A, Payal AR, Gonzalez-Gonzalez LA, Cakiner-Egilmez T, Chomsky AS, Vollman DE, Baze EF, Lawrence M, Daly MK. Cataract Surgery Outcomes in Glaucomatous Eyes: Results From the Veterans Affairs Ophthalmic Surgery Outcomes Data Project. Am J Ophthalmol. 2015 Oct;160(4):693-701.e1. doi:10.1016/j.ajo.2015.07.020. Epub 2015 Jul 22. PubMed PMID: 26210863.

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