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Randomized Controlled Trial
. 2012 Sep;119(9):1826-31.
doi: 10.1016/j.ophtha.2012.02.050. Epub 2012 May 16.

Reduction in intraocular pressure after cataract extraction: the Ocular Hypertension Treatment Study

Steven L Mansberger  1 , Mae O Gordon, Henry Jampel, Anjali Bhorade, James D Brandt, Brad Wilson, Michael A Kass; Ocular Hypertension Treatment Study Group
Affiliations
Randomized Controlled Trial

Reduction in intraocular pressure after cataract extraction: the Ocular Hypertension Treatment Study

Steven L Mansberger et al. Ophthalmology. 2012 Sep.

Abstract

Purpose: To determine the change in intraocular pressure (IOP) after cataract extraction in the observation group of the Ocular Hypertension Treatment Study.

Design: Comparative case series.

Participants: Forty-two participants (63 eyes) who underwent cataract surgery in at least 1 eye during the study and a control group of 743 participants (743 eyes) who did not undergo cataract surgery.

Methods: We defined the "split date" as the study visit date at which cataract surgery was reported in the cataract surgery group and a corresponding date in the control group. Preoperative IOP was defined as the mean IOP of up to 3 visits before the split date. Postoperative IOP was the mean IOP of up to 3 visits including the split date (0, 6, and 12 months' with "0 months" equaling the split date). In both groups, we censored data after initiation of ocular hypotensive medication or glaucoma surgery of any kind.

Main outcome measures: Difference in preoperative and postoperative IOP.

Results: In the cataract group, postoperative IOP was significantly lower than the preoperative IOP (19.8 ± 3.2 mmHg vs. 23.9 ± 3.2 mmHg; P<0.001). The postoperative IOP remained lower than the preoperative IOP for at least 36 months. The average decrease in postoperative IOP from preoperative IOP was 16.5%, and 39.7% of eyes had postoperative IOP ≥ 20% below preoperative IOP. A greater reduction in postoperative IOP occurred in the eyes with the highest preoperative IOP. In the control group, the corresponding mean IOPs were 23.8 ± 3.6 before the split date and 23.4 ± 3.9 after the split date.

Conclusions: Cataract surgery decreases IOP in patients with ocular hypertension over a long period of time.

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Figures

Figure 1
Figure 1
Flowchart of participants included into the current report of the Intraocular pressure (IOP) change after cataract surgery in the Ocular Hypertension Treatment Study (OHTS). The cataract group includes 63 eyes of 42 participants who had cataract surgery and the control group includes 743 eyes of 743 participants. Split date is the date that the participant reported cataract surgery. *Two participants in the cataract group had more than one exclusion criteria.
Figure 2
Figure 2
Intraocular pressure (IOP) before and after cataract surgery in the Ocular Hypertension Treatment Study. Month 0 is the split date or the study visit that the participant reported cataract surgery, or a randomly selected, corresponding date in the control group. Preoperative IOP was the mean IOP of up to 3 visits prior to the split date. Postoperative IOP was the mean IOP of up to 3 visits including the split date (0, 6, and 12 months). In the cataract surgery group, the mean postoperative IOP was lower than the mean preoperative IOP (23.9 ± 3.2 vs.19.8 ± 3.2 mm Hg, p<.0001, mixed model analysis of variance). In the control group, the mean IOP before and after the split date IOP were 23.8 ± 3.6 vs. 23.4 ± 3.9 mm Hg, p<.002, respectively. Error bars are ± two standard errors of the mean.
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References

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