Ten-year outcomes of cataract surgery for glaucoma management in patients with primary angle-closure disease

Purpose To investigate the long-term outcomes of cataract surgery for glaucoma management in patients with primary angle-closure disease (PACD). Study design Retrospective case series. Methods We reviewed the medical records of 87 eyes of 87 patients with PACD who underwent uncomplicated cataract su...

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Published in:Japanese journal of ophthalmology 2023-03, Vol.67 (2), p.129-137
Main Authors: Sakai, Daiki, Yamamoto, Shogo, Yoshimizu, Satoru, Hirose, Fumitaka, Fujihara, Masashi, Nakamura, Makoto, Kurimoto, Yasuo
Format: Article
Language:English
Subjects:
Cataract - complications
Cataract Extraction
Cataracts
Clinical Investigation
Eye
Eye surgery
Glaucoma
Glaucoma - complications
Glaucoma, Angle-Closure - complications
Glaucoma, Angle-Closure - surgery
Health care facilities
Health services
Humans
Intraocular Pressure
Medical records
Medicine
Medicine & Public Health
Ophthalmology
Patients
Retrospective Studies
Surgery
Visual field
Visual fields
Visual observation
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Summary:Purpose To investigate the long-term outcomes of cataract surgery for glaucoma management in patients with primary angle-closure disease (PACD). Study design Retrospective case series. Methods We reviewed the medical records of 87 eyes of 87 patients with PACD who underwent uncomplicated cataract surgery alone at the Kobe City Medical Center General Hospital. Only patients with a minimum follow-up of 10 years were included. The patients were divided into PACD spectrum categories: primary angle-closure glaucoma (PACG), primary-angle closure (PAC), and primary angle-closure suspect (PACS). The treatment outcomes were compared among the 3 groups. Intraocular pressure (IOP), number of glaucoma eye drops, requirement of additional glaucoma treatment, visual field progression, and progression to glaucoma during the follow-up period were evaluated. Results Among the 87 patients, 39 had PACG; 26, PAC; and 22, PACS. Ten years after surgery, the IOP had significantly decreased from baseline in all 3 groups. The rate of requirement of additional glaucoma treatment during the follow-up period was significantly higher in the PACG group than in the other groups. Almost half of the patients with PACG required additional glaucoma treatment; of those patients, six (15.4%) underwent glaucoma surgery. Three patients (11.5%) with PAC required additional glaucoma medication. Visual field progression was observed in 28.1% of the patients with PACG. In 1 patient with PAC, the condition progressed to PACG, but there was no such progression in any of the patients with PACS. Conclusions We confirmed that cataract surgery had a long-term (> 10 years) effect on IOP reduction in eyes with PACD. Early intervention with cataract surgery may be preferable for glaucoma management in patients with PACD.
ISSN:0021-5155
1613-2246
DOI:10.1007/s10384-022-00971-8