Effect of phacoemulsification on intraocular pressure in eyes with pseudoexfoliation: single-surgeon series

J Cataract Refract Surg. 2008 Nov;34(11):1834-41. doi: 10.1016/j.jcrs.2008.07.025.


Purpose: To assess the effect of phacoemulsification with posterior chamber intraocular lens (IOL) implantation performed by a single surgeon on intraocular pressure (IOP) and glaucoma medication requirements in pseudoexfoliation (PFX) eyes with or without glaucoma.

Setting: Private practice, Boston, Massachusetts, USA.

Methods: This retrospective analysis comprised 1122 eyes with PFX having uneventful phacoemulsification with IOL implantation. Of the eyes, 882 did not have glaucoma (PFX group) and 240 had glaucoma (PXG group). A comparative outcomes analysis was performed; the analysis focused on IOP and change in glaucoma medication requirements between the 2 groups.

Results: The mean IOP was statistically significantly reduced through 7 years postoperatively compared with preoperatively in the PFX group. The PXG group had reduced mean IOP for 1 year and reduced glaucoma medication requirements at almost all postoperative time intervals. Higher mean preoperative IOP was associated with a greater reduction in mean IOP postoperatively in both groups. Intraocular pressure spikes (> 30 mm Hg) 1 day postoperatively occurred in 4% in the PFX group and 17% in the PXG group. Postoperatively, 2.7% of PFX eyes progressed to a need for glaucoma medication and 3.7% of PXG eyes progressed to a need for laser and/or glaucoma surgery.

Conclusions: A long-term reduction in mean IOP occurred in PFX eyes with and without glaucoma. The IOP reduction was proportional to the preoperative IOP; higher preoperative IOP was associated with a greater reduction in IOP. Glaucoma progression in both groups was low, suggesting a protective effect of phacoemulsification on IOP in these eyes.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Disease Progression
  • Exfoliation Syndrome / complications*
  • Female
  • Glaucoma, Open-Angle / etiology
  • Glaucoma, Open-Angle / physiopathology
  • Glaucoma, Open-Angle / prevention & control*
  • Humans
  • Intraocular Pressure*
  • Lens Implantation, Intraocular*
  • Male
  • Phacoemulsification*
  • Retrospective Studies
  • Tonometry, Ocular
  • Visual Acuity