TY - JOUR
T1 - Cataract Surgery Outcomes in Glaucomatous Eyes
T2 - Results from the Veterans Affairs Ophthalmic Surgery Outcomes Data Project
AU - Turalba, Angela
AU - Payal, Abhishek R.
AU - Gonzalez-Gonzalez, Luis A.
AU - Cakiner-Egilmez, Tulay
AU - Chomsky, Amy S.
AU - Vollman, David E.
AU - Baze, Elizabeth F.
AU - Lawrence, Mary
AU - Daly, Mary K.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Purpose To compare visual acuity outcomes, vision-related quality of life, and complications related to cataract surgery in eyes with and without glaucoma. Design Retrospective cohort study. Methods Cataract surgery outcomes in cases with and without glaucoma from the Veterans Affairs Ophthalmic Surgical Outcomes Data Project were compared. Results We identified 608 glaucoma cases and 4306 controls undergoing planned cataract surgery alone. After adjusting for age, pseudoexfoliation, small pupil, prior ocular surgery, and anterior chamber depth, we found that glaucoma cases were more likely to have posterior capsular tear with vitrectomy (odds ratio [OR] 1.8, P =.03) and sulcus intraocular lens placement (OR 1.65, P =.03) during cataract surgery. Glaucoma cases were more likely to have postoperative inflammation (OR 1.73, P <.0001), prolonged elevated intraocular pressure (OR 2.96, P =.0003), and additional surgery within 30 days (OR 1.92, P =.03). Mean best-corrected visual acuity (BCVA) and Visual Function Questionnaire (VFQ) scores significantly improved after cataract surgery in both groups (P <.0001), but there were larger improvements in BCVA (P =.01) and VFQ composite scores (P <.0001) in the nonglaucoma vs the glaucoma group. A total of 3621 nonglaucoma cases (94.1%) had postoperative BCVA 20/40 or better, compared to 466 glaucoma cases (89.6%) (P =.0003). Conclusions Eyes with glaucoma are at increased risk for complications and have more modest visual outcomes after cataract surgery compared to eyes without glaucoma. Despite this, glaucoma patients still experience significant improvement in vision-related outcomes after cataract extraction. Further study is needed to explore potential factors that influence cataract surgery outcomes in glaucomatous eyes.
AB - Purpose To compare visual acuity outcomes, vision-related quality of life, and complications related to cataract surgery in eyes with and without glaucoma. Design Retrospective cohort study. Methods Cataract surgery outcomes in cases with and without glaucoma from the Veterans Affairs Ophthalmic Surgical Outcomes Data Project were compared. Results We identified 608 glaucoma cases and 4306 controls undergoing planned cataract surgery alone. After adjusting for age, pseudoexfoliation, small pupil, prior ocular surgery, and anterior chamber depth, we found that glaucoma cases were more likely to have posterior capsular tear with vitrectomy (odds ratio [OR] 1.8, P =.03) and sulcus intraocular lens placement (OR 1.65, P =.03) during cataract surgery. Glaucoma cases were more likely to have postoperative inflammation (OR 1.73, P <.0001), prolonged elevated intraocular pressure (OR 2.96, P =.0003), and additional surgery within 30 days (OR 1.92, P =.03). Mean best-corrected visual acuity (BCVA) and Visual Function Questionnaire (VFQ) scores significantly improved after cataract surgery in both groups (P <.0001), but there were larger improvements in BCVA (P =.01) and VFQ composite scores (P <.0001) in the nonglaucoma vs the glaucoma group. A total of 3621 nonglaucoma cases (94.1%) had postoperative BCVA 20/40 or better, compared to 466 glaucoma cases (89.6%) (P =.0003). Conclusions Eyes with glaucoma are at increased risk for complications and have more modest visual outcomes after cataract surgery compared to eyes without glaucoma. Despite this, glaucoma patients still experience significant improvement in vision-related outcomes after cataract extraction. Further study is needed to explore potential factors that influence cataract surgery outcomes in glaucomatous eyes.
UR - http://www.scopus.com/inward/record.url?scp=84941422046&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2015.07.020
DO - 10.1016/j.ajo.2015.07.020
M3 - Article
C2 - 26210863
AN - SCOPUS:84941422046
SN - 0002-9394
VL - 160
SP - 693-701.e1
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 4
ER -