The effect of cataract extraction on intraocular pressure

Anurag Shrivastava, Kuldev Singh

Research output: Contribution to journalArticle

106 Citations (Scopus)

Abstract

Purpose of review: To review the current ophthalmic literature regarding the impact of modern cataract surgery on intraocular pressure (IOP). Recent findings: Many articles in the literature demonstrate a modest, long-lasting decrease in IOP following phacoemulsification and posterior chamber intraocular lens implantation in patients with primary open-angle glaucoma and ocular hypertension. The mechanism of this average pressure-lowering effect has yet to be elucidated. The IOP reductions obtained in patients with angle closure glaucoma are often more pronounced than those seen in patients with open angles. Patients with higher levels of preoperative IOP obtain greater average reductions in IOP, although this phenomenon may partially be explained by a statistical effect known as regression to the mean. Summary: Although it is well recognized that phacoemulsification may result in a modest sustained reduction in IOP, there are several limitations in the studies that have assessed the magnitude of this effect. The implications of such IOP reduction with cataract surgery on the medical and surgical algorithms for care in patients with open-angle glaucoma and coexistent cataract remain unclear. In contrast, the substantial benefits of cataract surgery in patients with acute and chronic angle-closure glaucoma have been well studied and are generally widely accepted. An improved understanding of the pathophysiological mechanisms of IOP lowering after cataract extraction may help us better predict which patients are most likely to benefit from simple cataract extraction, obviating the need for combined cataract and glaucoma surgical procedures in such circumstances.

Original languageEnglish (US)
Pages (from-to)118-122
Number of pages5
JournalCurrent Opinion in Ophthalmology
Volume21
Issue number2
DOIs
StatePublished - Mar 2010

Fingerprint

Cataract Extraction
Intraocular Pressure
Cataract
Angle Closure Glaucoma
Phacoemulsification
Ocular Hypertension
Intraocular Lens Implantation
Open Angle Glaucoma
Glaucoma
Patient Care
Pressure

Keywords

  • Cataract surgery
  • Glaucoma
  • Intraocular pressure
  • Phacoemulsification

ASJC Scopus subject areas

  • Ophthalmology

Cite this

The effect of cataract extraction on intraocular pressure. / Shrivastava, Anurag; Singh, Kuldev.

In: Current Opinion in Ophthalmology, Vol. 21, No. 2, 03.2010, p. 118-122.

Research output: Contribution to journalArticle

@article{f8c6fba55d53465e91a348a63f7c3dea,
title = "The effect of cataract extraction on intraocular pressure",
abstract = "Purpose of review: To review the current ophthalmic literature regarding the impact of modern cataract surgery on intraocular pressure (IOP). Recent findings: Many articles in the literature demonstrate a modest, long-lasting decrease in IOP following phacoemulsification and posterior chamber intraocular lens implantation in patients with primary open-angle glaucoma and ocular hypertension. The mechanism of this average pressure-lowering effect has yet to be elucidated. The IOP reductions obtained in patients with angle closure glaucoma are often more pronounced than those seen in patients with open angles. Patients with higher levels of preoperative IOP obtain greater average reductions in IOP, although this phenomenon may partially be explained by a statistical effect known as regression to the mean. Summary: Although it is well recognized that phacoemulsification may result in a modest sustained reduction in IOP, there are several limitations in the studies that have assessed the magnitude of this effect. The implications of such IOP reduction with cataract surgery on the medical and surgical algorithms for care in patients with open-angle glaucoma and coexistent cataract remain unclear. In contrast, the substantial benefits of cataract surgery in patients with acute and chronic angle-closure glaucoma have been well studied and are generally widely accepted. An improved understanding of the pathophysiological mechanisms of IOP lowering after cataract extraction may help us better predict which patients are most likely to benefit from simple cataract extraction, obviating the need for combined cataract and glaucoma surgical procedures in such circumstances.",
keywords = "Cataract surgery, Glaucoma, Intraocular pressure, Phacoemulsification",
author = "Anurag Shrivastava and Kuldev Singh",
year = "2010",
month = "3",
doi = "10.1097/ICU.0b013e3283360ac3",
language = "English (US)",
volume = "21",
pages = "118--122",
journal = "Current Opinion in Ophthalmology",
issn = "1040-8738",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - The effect of cataract extraction on intraocular pressure

AU - Shrivastava, Anurag

AU - Singh, Kuldev

PY - 2010/3

Y1 - 2010/3

N2 - Purpose of review: To review the current ophthalmic literature regarding the impact of modern cataract surgery on intraocular pressure (IOP). Recent findings: Many articles in the literature demonstrate a modest, long-lasting decrease in IOP following phacoemulsification and posterior chamber intraocular lens implantation in patients with primary open-angle glaucoma and ocular hypertension. The mechanism of this average pressure-lowering effect has yet to be elucidated. The IOP reductions obtained in patients with angle closure glaucoma are often more pronounced than those seen in patients with open angles. Patients with higher levels of preoperative IOP obtain greater average reductions in IOP, although this phenomenon may partially be explained by a statistical effect known as regression to the mean. Summary: Although it is well recognized that phacoemulsification may result in a modest sustained reduction in IOP, there are several limitations in the studies that have assessed the magnitude of this effect. The implications of such IOP reduction with cataract surgery on the medical and surgical algorithms for care in patients with open-angle glaucoma and coexistent cataract remain unclear. In contrast, the substantial benefits of cataract surgery in patients with acute and chronic angle-closure glaucoma have been well studied and are generally widely accepted. An improved understanding of the pathophysiological mechanisms of IOP lowering after cataract extraction may help us better predict which patients are most likely to benefit from simple cataract extraction, obviating the need for combined cataract and glaucoma surgical procedures in such circumstances.

AB - Purpose of review: To review the current ophthalmic literature regarding the impact of modern cataract surgery on intraocular pressure (IOP). Recent findings: Many articles in the literature demonstrate a modest, long-lasting decrease in IOP following phacoemulsification and posterior chamber intraocular lens implantation in patients with primary open-angle glaucoma and ocular hypertension. The mechanism of this average pressure-lowering effect has yet to be elucidated. The IOP reductions obtained in patients with angle closure glaucoma are often more pronounced than those seen in patients with open angles. Patients with higher levels of preoperative IOP obtain greater average reductions in IOP, although this phenomenon may partially be explained by a statistical effect known as regression to the mean. Summary: Although it is well recognized that phacoemulsification may result in a modest sustained reduction in IOP, there are several limitations in the studies that have assessed the magnitude of this effect. The implications of such IOP reduction with cataract surgery on the medical and surgical algorithms for care in patients with open-angle glaucoma and coexistent cataract remain unclear. In contrast, the substantial benefits of cataract surgery in patients with acute and chronic angle-closure glaucoma have been well studied and are generally widely accepted. An improved understanding of the pathophysiological mechanisms of IOP lowering after cataract extraction may help us better predict which patients are most likely to benefit from simple cataract extraction, obviating the need for combined cataract and glaucoma surgical procedures in such circumstances.

KW - Cataract surgery

KW - Glaucoma

KW - Intraocular pressure

KW - Phacoemulsification

UR - http://www.scopus.com/inward/record.url?scp=76949108453&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=76949108453&partnerID=8YFLogxK

U2 - 10.1097/ICU.0b013e3283360ac3

DO - 10.1097/ICU.0b013e3283360ac3

M3 - Article

C2 - 20040874

AN - SCOPUS:76949108453

VL - 21

SP - 118

EP - 122

JO - Current Opinion in Ophthalmology

JF - Current Opinion in Ophthalmology

SN - 1040-8738

IS - 2

ER -