Efficacy of Cataract Surgery in Lowering IOP in Small Eyes with Shallow Anterior Chamber

Abstract

Shruthi Kavinamoole

Aim To evaluate the efficacy of cataract extraction in lowering IOP in patients with small eyes and shallow AC.

Setting Manjunatha eye hospital, Kundapura, Udupi.

Design Clinical prospective study

Materials and Methods A prospective observational study was conducted in 55 eyes of 47 patients attending the outpatient department of Manjunatha Eye hospital, Kundapura, Udupi. The study period was between 01/05/2022 to 30/04/2023. Patients belonging to either sex irrespective of age who had senile cataract of any grade with AC depth – Van Hericks’ grade 1-2 ,with short axial length – ≤ 22mm and/or Intraocular pressure ≥18mmHg or a difference of >5mmHg from fellow eye were included in this study. Traumatic, complicated or secondary cataracts and those who were already on anti-glaucoma medications were excluded. These patients underwent basic eye examinations and systemic evaluation followed by phacoemulsification with foldable IOL implantation under peribulbar block. Postoperatively BCVA, IOP, AC depth were evaluated.

Statistical Analysis Descriptive statistics

Results A total of 55 eyes of 47 patients were included in this study. 32 were females and 15 were males. 55eyes had various grades of cataract. Axial length of 55eyes were between range of 20.59mm to 22mm. Intraocular pressure were in the range of 18mmHg – 26mmHg. 1 week postoperative follow up showed all the eyes with BCVA of 6/6 with deepening of AC depth grade 3 PACD. AS-OCT done at 1week post op day showed widening of AC angle. Intraocular pressure postoperatively were in the range of 14mmHg –18mmHg.

Conclusion Cataract extraction alone is the most effective way to lower IOP in a cataractous patient with high IOP with short axial length. This avoids the need of combined trabeculectomy with cataract surgery and long term antiglaucoma medications.

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