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. 2024 Jul 15;16(7):2889-2897.
doi: 10.62347/RMIA8846. eCollection 2024.

Influence of preoperative dilation time on the effect of cataract ultrasonography combined with goniostomy in patients with primary closed angle glaucoma and its clinical significance

Yan Dai  1 , Yuhuan Liu  1 , Anlang Dai  2 , Yaozeng Wang  3
Affiliations

Influence of preoperative dilation time on the effect of cataract ultrasonography combined with goniostomy in patients with primary closed angle glaucoma and its clinical significance

Yan Dai et al. Am J Transl Res. .

Abstract

Objective: To evaluate the impact of preoperative pupil dilation time on the outcomes of cataract ultrasonoemulsification combined with goniostomy in patients with primary angle-closure glaucoma (PACG).

Methods: A retrospective analysis was conducted on 106 PACG patients who underwent cataract ultrasonoemulsification with goniostomy. Patients were divided into two groups based on pupil dilation times: group A (dilation time between 20 to 30 minutes) and group B (dilation time between 30 minutes to 1 hour). Pre- and postoperative intraocular pressure (IOP), visual acuity, pupil diameter, anterior chamber depth (ACD), and lens thickness (LT) were measured. Surgical time and cumulative dissipated energy (CDE) were also analyzed. Multivariate analysis was performed to identify independent risk factors for postoperative complications.

Results: Both groups showed significant postoperative improvement in visual acuity (P < 0.05). Group B exhibited significantly lower postoperative IOP than group A (P < 0.05). There were significant increases in ACD and pupil diameter and a decrease in LT post-dilation in both groups (all P < 0.05). Group B showed a deeper ACD, thinner LT, and larger pupil diameter compared to group A (all P < 0.05). While CDE was similar between groups, operation duration was longer in group A (P < 0.05). Disease course > 5.5 years, preoperative IOP > 25.14 mmHg, pupil diameter before dilation < 4.895 mm, ACD before dilation < 2.105 mm, and dilation time ≤ 30 minutes were independent risk factors for postoperative complications.

Conclusion: Preoperative pupil dilation time > 30 minutes leads to better surgical outcome. Several preoperative factors, including dilation time ≤ 30 minutes, are independent risk factors for postoperative complications.

Keywords: Dilation time; cataract ultrasonography; goniostomy; primary closed-angle glaucoma.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Research flow chart.
Figure 2
Figure 2
Improvement in visual acuity (A) and IPO (B) before and after surgery. ***, P < 0.001; #, P < 0.05, compare with pre-operative level. IOP: Intraocular Pressure.
Figure 3
Figure 3
Changes in pupil diameter (A), ACD (B), and LT (C) before and after pupil dilation. ***, P < 0.001; #, P < 0.05, compared to before dilation. ACD: anterior chamber depth; LT: lens thickness.
Figure 4
Figure 4
Comparison of operative time (A) and CDE (B) in two groups of patients. ***, P < 0.001. CDE: cumulative dissipated energy.
Figure 5
Figure 5
Forest plot of single factor analysis that may affect patients’ postoperative complications.
Figure 6
Figure 6
ROC curves for various factors in predicting postoperative complications. A. Age; B. Disease course; C. Preoperative IPO; D. Pupil diameter before dilation; E. ACD before dilation; F. LT before dilation.
Figure 7
Figure 7
Forest plot of independent risk factors affecting patients’ postoperative complications through multi-factor analysis.
See this image and copyright information in PMC

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