The Effect of Phacoemulsification on Intraocular Pressure in Primary Angle Closure Glaucoma (PACG) Patients at Phanatnikhom Hospital, Chonburi Province
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Abstract
BACKGROUND: Primary angle closure glaucoma (PACG) is a leading cause of blindness worldwide, including in Thailand. This problem impacts the overall health of populations and healthcare systems globally. Treatment guidelines for each stage are different. Therefore, the factors that affect treatment should be explored to plan for appropriate patient care in the future.
OBJECTIVES: The study aimed to examine the effects of cataract surgery by phaco-emulsification on intraocular pressure and to determine the factors associated with intraocular pressure among primary angle closure glaucoma patients.
METHODS: A retrospective descriptive study was conducted on 121 patients with primary angle closure glaucoma who had undergone phacoemulsification between October 1st 2017 and September 30th 2022. The preoperative and postoperative record forms were used as the research instrument. Information concerning visual acuity, intraocular pressure, the number of glaucoma medications and ocular biometric parameters was collected. Descriptive statistics, Paired sample t-test, Repeated measures ANOVA, and Multiple linear regression were used to analyze the outcomes. A p-value <0.05 was considered statistically significant.
RESULTS: From the total of 121 patients, most were female (79.3%), and the mean age was 67.9±8.4 years old. Mean postoperative Intraocular pressure (IOP) decreased significantly from 17.9±5.1 at baseline to 12.1±2.5 mmHg (p<0.001). Eyes with higher preoperative IOP had the greatest IOP-lowering effect (p<0.001), while visual acuity improved significantly (logMAR decreased 0.8, p<0.001) and the number of glaucoma medications decreased significantly (p<0.001). Preoperative IOP was the important factor affected by IOP reduction (β=0.86, p<0.001).
CONCLUSIONS: Phacoemulsification not only improves visual acuity but also enables a significant decrease in IOP and glaucoma medications. Preoperative IOP is associated with a decrease in postoperative IOP. However, other ocular biometric parameters should be examined to predict the association of preoperative IOP reduction and plan for patient care in the future.
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