Predicting IOP reduction after cataract surgery using preoperative biometric data

shahin Yazdani1 , Maryam Fakhri1 *, Farideh Sharifipour1 , Azadeh Doozandeh2

  1. Department of ophthalmology and Research institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  2. Department of Ophthalmology and Research Institute for Opthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract: Intraocular pressure (IOP) changes following phacoemulsification (PE) and their correlation with ocular biometric parameters have attracted significant interest. We aimed to assess preoperative biometric parameters and reach a formula for predicting IOP reduction after PE.

Methods: A total of 115 eyes of 95 patients with normal open (n=58) or narrow angles (n=57) undergoing PE were included. IOP was measured pre- and postoperatively at 1, 3 and 6 months. Multivariate regression analysis was used to determine the best predictive parameters and the optimal combination of factors.

Results: Age was comparable (p=0.6), but preoperative IOP was higher (p<0.001) and female gender was more prevalent (p=0.03) in angle closure. Mean IOP reduction at 6 months was significantly greater in angle closure (16.5%) as compared to normal eyes (8.6%). Factors significantly associated with IOP reduction on univariate analysis were preoperative IOP (r=0.7), anterior chamber depth (ACD) (r=-0.4), lens thickness (r=0.4) and axial length (r=-0.2). After multivariate analysis, preoperative IOP (ß =0.6, P<0.001) and ACD (ß =-0.7, P=0.012) remained the only significant predictors. The best formula correlated with IOP reduction was: -7.64 + (0.6*preoperative IOP) – (0.7*ACD) (r=0.7) which performed better than a formula utilizing the PD ratio (preoperative IOP/ACD) (r=0.4), especially in eyes with higher preoperative IOP.

Conclusion: Although numerous biometric parameters impact IOP changes after cataract surgery, ACD and preoperative IOP are the strongest predictors. The suggested formula displayed good performance for estimation of IOP reduction after PE.





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