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KMID : 1813520230120010007
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Journal of the Korean Glaucoma Society
2023 Volume.12 No. 1 p.7 ~ p.13
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Preventing Intraocular Pressure Elevation after Phacoemulsification in Normal Tension Glaucoma or Pseudoexfoliation Syndrome with Oral Acetazolamide
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Kim Hyun-Woo
Lee Kyoo-Won
Lee Chang-Hoon
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Abstract
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Purpose : To investigate the frequency of early postoperative intraocular pressure (IOP) elevation following phacoemulsification in patients with normal tension glaucoma (NTG) and pseudoexfoliation syndrome (PXF) and to confirm the prophylactic effect of oral acetazolamide against early IOP spike.
Methods : In this retrospective study, 66 eyes of patients with normal eyes, 67 with medically well-controlled NTG, and 67 with PFX, who underwent routine cataract extraction and intraocular lens implantation were allocated to two treatment groups; one was given preoperative oral acetazolamide and the other one was not. IOP was measured preoperatively and 3 and 24 hours postoperatively. A postoperative IOP spike was defined as IOP greater than 25 mmHg.
Results : Mean preoperative IOP was not significantly different among the patients in normal, NTG, PXF groups, respectively (p = 0.215). Postoperative IOP spike at 3 hours occurred more frequently in NTG group (15 eyes, 22.4%) and in PXF group (8 eyes, 11.9%) compared to the 4 eyes (6.06%) of normal group (p = 0.020). IOP spike at 1 day was not observed in normal group, while it was observed in 4 eyes (5.97%) of NTG and 5 eyes (7.46%) of PXF groups. The incidence was significantly higher in the NTG and PXF groups (p = 0.023). Preoperative acetazolamide administration was effective in significantly reducing the early postoperative IOP spike at in normal eyes, NTG, and PXF groups (p = 0.035, 0.009, 0.007, respectively).
Conclusions : A significant proportion of patients with NTG and PXF had an IOP spike shortly after cataract surgery. Administration of preoperative oral acetazolamide significantly reduced the IOP spike in these eyes.
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KEYWORD
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Intraocular pressure, Normal tension glaucoma, Phacoemulsification, Pseudoexfoliation syndrome
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