Refractive Outcomes of Combined Cataract and Glaucoma Surgery

PURPOSE:This study was designed to evaluate the refractive outcomes of combined cataract extraction and glaucoma surgery. DESIGN:Retrospective case series. METHODS:A retrospective chart review of patients undergoing simultaneous cataract extraction with trabeculectomy or glaucoma drainage device sur...

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Veröffentlicht in:Journal of glaucoma 2015-02, Vol.24 (2), p.161-164
Hauptverfasser: Tzu, Jonathan H, Shah, Christopher T, Galor, Anat, Junk, Anna K, Sastry, Ananth, Wellik, Sarah R
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container_end_page 164
container_issue 2
container_start_page 161
container_title Journal of glaucoma
container_volume 24
creator Tzu, Jonathan H
Shah, Christopher T
Galor, Anat
Junk, Anna K
Sastry, Ananth
Wellik, Sarah R
description PURPOSE:This study was designed to evaluate the refractive outcomes of combined cataract extraction and glaucoma surgery. DESIGN:Retrospective case series. METHODS:A retrospective chart review of patients undergoing simultaneous cataract extraction with trabeculectomy or glaucoma drainage device surgery was performed. The main outcome measure evaluated was whether or not spherical equivalent of −1.00 to +0.50 D was achieved at 3 to 6 months postoperatively. Secondary outcomes includedreduction in intraocular pressure, amount of cylinder induced by combined surgery, and individual patient characteristics that may have affected refractive outcome. Outcomes were compared with an age-matched and sex-matched control group of patients who had uncomplicated cataract surgery during the same time period. RESULTS:Forty-three eyes of 36 patients underwent combined cataract extraction and glaucoma surgery. A refractive outcome of spherical equivalent between −1.00 and +0.50 D was achieved in 32 of 43 eyes (74%) at 3 to 6 months after surgery. Logistic regression analysis found a 1.14 increased risk of the refraction being outside this defined refractive range in older compared with younger patients (by year, 95% CI, 1.04-1.27). Type of lens implant used, type of glaucoma surgery, and preoperative best-corrected visual acuity did not significantly affect refractive outcome. In a subset of 22 eyes with available preoperative keratometry measures, a mean 1.31 D (SD=0.86; range, 0.26 to 3.76) of corneal astigmatism was induced by combined surgery. In comparison, a matched control group who had cataract surgery alone achieved target refractive outcome in 34 of 40 eyes (85%, P=0.001) and had a trend for less induced cylinder (0.99, SD=0.72, P=0.11). CONCLUSIONS:Favorable refractive outcomes were achieved in the majority of patients despite the potential alteration of preoperative measurements and introduction of error into lens selection when using a combined approach. There does not seem to be a difference in the refractive outcome with regard to the type of glaucoma surgery performed. Control patients who had cataract surgery alone had a higher percentage of achieving target refractive goal and less induced cylinder.
doi_str_mv 10.1097/01.ijg.0000435773.20279.56
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DESIGN:Retrospective case series. METHODS:A retrospective chart review of patients undergoing simultaneous cataract extraction with trabeculectomy or glaucoma drainage device surgery was performed. The main outcome measure evaluated was whether or not spherical equivalent of −1.00 to +0.50 D was achieved at 3 to 6 months postoperatively. Secondary outcomes includedreduction in intraocular pressure, amount of cylinder induced by combined surgery, and individual patient characteristics that may have affected refractive outcome. Outcomes were compared with an age-matched and sex-matched control group of patients who had uncomplicated cataract surgery during the same time period. RESULTS:Forty-three eyes of 36 patients underwent combined cataract extraction and glaucoma surgery. A refractive outcome of spherical equivalent between −1.00 and +0.50 D was achieved in 32 of 43 eyes (74%) at 3 to 6 months after surgery. Logistic regression analysis found a 1.14 increased risk of the refraction being outside this defined refractive range in older compared with younger patients (by year, 95% CI, 1.04-1.27). Type of lens implant used, type of glaucoma surgery, and preoperative best-corrected visual acuity did not significantly affect refractive outcome. In a subset of 22 eyes with available preoperative keratometry measures, a mean 1.31 D (SD=0.86; range, 0.26 to 3.76) of corneal astigmatism was induced by combined surgery. In comparison, a matched control group who had cataract surgery alone achieved target refractive outcome in 34 of 40 eyes (85%, P=0.001) and had a trend for less induced cylinder (0.99, SD=0.72, P=0.11). CONCLUSIONS:Favorable refractive outcomes were achieved in the majority of patients despite the potential alteration of preoperative measurements and introduction of error into lens selection when using a combined approach. There does not seem to be a difference in the refractive outcome with regard to the type of glaucoma surgery performed. Control patients who had cataract surgery alone had a higher percentage of achieving target refractive goal and less induced cylinder.</description><identifier>ISSN: 1057-0829</identifier><identifier>EISSN: 1536-481X</identifier><identifier>DOI: 10.1097/01.ijg.0000435773.20279.56</identifier><identifier>PMID: 24247998</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Aged ; Aged, 80 and over ; Cataract - complications ; Cataract - physiopathology ; Female ; Glaucoma - complications ; Glaucoma - physiopathology ; Glaucoma - surgery ; Glaucoma Drainage Implants ; Humans ; Intraocular Pressure - physiology ; Lens Implantation, Intraocular ; Male ; Middle Aged ; Phacoemulsification - methods ; Prosthesis Implantation - methods ; Refraction, Ocular - physiology ; Retrospective Studies ; Trabeculectomy - methods ; Visual Acuity - physiology</subject><ispartof>Journal of glaucoma, 2015-02, Vol.24 (2), p.161-164</ispartof><rights>Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4446-26a7784cd3d950d589a8a86e728afcd67e2c26930c0d9fb79b973bdbd11fd21a3</citedby><cites>FETCH-LOGICAL-c4446-26a7784cd3d950d589a8a86e728afcd67e2c26930c0d9fb79b973bdbd11fd21a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24247998$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tzu, Jonathan H</creatorcontrib><creatorcontrib>Shah, Christopher T</creatorcontrib><creatorcontrib>Galor, Anat</creatorcontrib><creatorcontrib>Junk, Anna K</creatorcontrib><creatorcontrib>Sastry, Ananth</creatorcontrib><creatorcontrib>Wellik, Sarah R</creatorcontrib><title>Refractive Outcomes of Combined Cataract and Glaucoma Surgery</title><title>Journal of glaucoma</title><addtitle>J Glaucoma</addtitle><description>PURPOSE:This study was designed to evaluate the refractive outcomes of combined cataract extraction and glaucoma surgery. DESIGN:Retrospective case series. METHODS:A retrospective chart review of patients undergoing simultaneous cataract extraction with trabeculectomy or glaucoma drainage device surgery was performed. The main outcome measure evaluated was whether or not spherical equivalent of −1.00 to +0.50 D was achieved at 3 to 6 months postoperatively. Secondary outcomes includedreduction in intraocular pressure, amount of cylinder induced by combined surgery, and individual patient characteristics that may have affected refractive outcome. Outcomes were compared with an age-matched and sex-matched control group of patients who had uncomplicated cataract surgery during the same time period. RESULTS:Forty-three eyes of 36 patients underwent combined cataract extraction and glaucoma surgery. A refractive outcome of spherical equivalent between −1.00 and +0.50 D was achieved in 32 of 43 eyes (74%) at 3 to 6 months after surgery. Logistic regression analysis found a 1.14 increased risk of the refraction being outside this defined refractive range in older compared with younger patients (by year, 95% CI, 1.04-1.27). Type of lens implant used, type of glaucoma surgery, and preoperative best-corrected visual acuity did not significantly affect refractive outcome. In a subset of 22 eyes with available preoperative keratometry measures, a mean 1.31 D (SD=0.86; range, 0.26 to 3.76) of corneal astigmatism was induced by combined surgery. In comparison, a matched control group who had cataract surgery alone achieved target refractive outcome in 34 of 40 eyes (85%, P=0.001) and had a trend for less induced cylinder (0.99, SD=0.72, P=0.11). CONCLUSIONS:Favorable refractive outcomes were achieved in the majority of patients despite the potential alteration of preoperative measurements and introduction of error into lens selection when using a combined approach. There does not seem to be a difference in the refractive outcome with regard to the type of glaucoma surgery performed. Control patients who had cataract surgery alone had a higher percentage of achieving target refractive goal and less induced cylinder.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cataract - complications</subject><subject>Cataract - physiopathology</subject><subject>Female</subject><subject>Glaucoma - complications</subject><subject>Glaucoma - physiopathology</subject><subject>Glaucoma - surgery</subject><subject>Glaucoma Drainage Implants</subject><subject>Humans</subject><subject>Intraocular Pressure - physiology</subject><subject>Lens Implantation, Intraocular</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Phacoemulsification - methods</subject><subject>Prosthesis Implantation - methods</subject><subject>Refraction, Ocular - physiology</subject><subject>Retrospective Studies</subject><subject>Trabeculectomy - methods</subject><subject>Visual Acuity - physiology</subject><issn>1057-0829</issn><issn>1536-481X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkF1LwzAUhoMobk7_ghSvvGnNV5NGUJCiUxgM_ADvQpqkW2e7zqR17N-bOT9uPTfnXDzveeEB4AzBBEHBLyBKqsUsgWEoSTknCYaYiyRle2CIUsJimqHX_XDDlMcww2IAjrxfQBg4jA7BAFNMuRDZEFw92tIp3VUfNpr2nW4b66O2jPK2KaqlNVGuOrUFIrU00bhWfUBU9NS7mXWbY3BQqtrbk-89Ai93t8_5fTyZjh_ym0msKaUsxkxxnlFtiBEpNGkmVKYyZjnOVKkN4xZrzASBGhpRFlwUgpPCFAah0mCkyAic7_6uXPveW9_JpvLa1rVa2rb3ErEUU0QZIQG93KHatd47W8qVqxrlNhJBudUnIZJBn_zTJ7_0yZSF8Ol3T1801vxGf3wF4HoHrNu6s86_1f3aOjm3qu7m_2n4BK_Rfys</recordid><startdate>201502</startdate><enddate>201502</enddate><creator>Tzu, Jonathan H</creator><creator>Shah, Christopher T</creator><creator>Galor, Anat</creator><creator>Junk, Anna K</creator><creator>Sastry, Ananth</creator><creator>Wellik, Sarah R</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201502</creationdate><title>Refractive Outcomes of Combined Cataract and Glaucoma Surgery</title><author>Tzu, Jonathan H ; Shah, Christopher T ; Galor, Anat ; Junk, Anna K ; Sastry, Ananth ; Wellik, Sarah R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4446-26a7784cd3d950d589a8a86e728afcd67e2c26930c0d9fb79b973bdbd11fd21a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cataract - complications</topic><topic>Cataract - physiopathology</topic><topic>Female</topic><topic>Glaucoma - complications</topic><topic>Glaucoma - physiopathology</topic><topic>Glaucoma - surgery</topic><topic>Glaucoma Drainage Implants</topic><topic>Humans</topic><topic>Intraocular Pressure - physiology</topic><topic>Lens Implantation, Intraocular</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Phacoemulsification - methods</topic><topic>Prosthesis Implantation - methods</topic><topic>Refraction, Ocular - physiology</topic><topic>Retrospective Studies</topic><topic>Trabeculectomy - methods</topic><topic>Visual Acuity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tzu, Jonathan H</creatorcontrib><creatorcontrib>Shah, Christopher T</creatorcontrib><creatorcontrib>Galor, Anat</creatorcontrib><creatorcontrib>Junk, Anna K</creatorcontrib><creatorcontrib>Sastry, Ananth</creatorcontrib><creatorcontrib>Wellik, Sarah R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of glaucoma</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tzu, Jonathan H</au><au>Shah, Christopher T</au><au>Galor, Anat</au><au>Junk, Anna K</au><au>Sastry, Ananth</au><au>Wellik, Sarah R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Refractive Outcomes of Combined Cataract and Glaucoma Surgery</atitle><jtitle>Journal of glaucoma</jtitle><addtitle>J Glaucoma</addtitle><date>2015-02</date><risdate>2015</risdate><volume>24</volume><issue>2</issue><spage>161</spage><epage>164</epage><pages>161-164</pages><issn>1057-0829</issn><eissn>1536-481X</eissn><abstract>PURPOSE:This study was designed to evaluate the refractive outcomes of combined cataract extraction and glaucoma surgery. DESIGN:Retrospective case series. METHODS:A retrospective chart review of patients undergoing simultaneous cataract extraction with trabeculectomy or glaucoma drainage device surgery was performed. The main outcome measure evaluated was whether or not spherical equivalent of −1.00 to +0.50 D was achieved at 3 to 6 months postoperatively. Secondary outcomes includedreduction in intraocular pressure, amount of cylinder induced by combined surgery, and individual patient characteristics that may have affected refractive outcome. Outcomes were compared with an age-matched and sex-matched control group of patients who had uncomplicated cataract surgery during the same time period. RESULTS:Forty-three eyes of 36 patients underwent combined cataract extraction and glaucoma surgery. A refractive outcome of spherical equivalent between −1.00 and +0.50 D was achieved in 32 of 43 eyes (74%) at 3 to 6 months after surgery. Logistic regression analysis found a 1.14 increased risk of the refraction being outside this defined refractive range in older compared with younger patients (by year, 95% CI, 1.04-1.27). Type of lens implant used, type of glaucoma surgery, and preoperative best-corrected visual acuity did not significantly affect refractive outcome. In a subset of 22 eyes with available preoperative keratometry measures, a mean 1.31 D (SD=0.86; range, 0.26 to 3.76) of corneal astigmatism was induced by combined surgery. In comparison, a matched control group who had cataract surgery alone achieved target refractive outcome in 34 of 40 eyes (85%, P=0.001) and had a trend for less induced cylinder (0.99, SD=0.72, P=0.11). CONCLUSIONS:Favorable refractive outcomes were achieved in the majority of patients despite the potential alteration of preoperative measurements and introduction of error into lens selection when using a combined approach. There does not seem to be a difference in the refractive outcome with regard to the type of glaucoma surgery performed. Control patients who had cataract surgery alone had a higher percentage of achieving target refractive goal and less induced cylinder.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>24247998</pmid><doi>10.1097/01.ijg.0000435773.20279.56</doi><tpages>4</tpages></addata></record>
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subjects Aged
Aged, 80 and over
Cataract - complications
Cataract - physiopathology
Female
Glaucoma - complications
Glaucoma - physiopathology
Glaucoma - surgery
Glaucoma Drainage Implants
Humans
Intraocular Pressure - physiology
Lens Implantation, Intraocular
Male
Middle Aged
Phacoemulsification - methods
Prosthesis Implantation - methods
Refraction, Ocular - physiology
Retrospective Studies
Trabeculectomy - methods
Visual Acuity - physiology
title Refractive Outcomes of Combined Cataract and Glaucoma Surgery
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