Does Cataract Extraction Significantly Affect Intraocular Pressure of Glaucomatous/Hypertensive Eyes? Meta-Analysis of Literature

Abstract

Background and Objectives: This study aimed to evaluate the effect of cataract extraction on intraocular pressure at 6, 12, and 24 months and their difference compared to the baseline in diverse glaucoma subtypes. Materials and Methods: We carried out research in the MEDLINE, Cochrane Library and EMBASE databases, as of April 2022 for relevant papers, filtered according to established inclusion and exclusion criteria. The meta-analysis evaluated the Mean Reduction and relative Standard Error in these subpopulations at predetermined times. A total of 41 groups (2302 eyes) were included in the systematic review. Due to the significant heterogeneity, they were analysed through a Random Effects Model. Results: We obtained these differences from baseline: (1) Open Angle Glaucoma at 6, 12 and 24 months, respectively: −2.44 mmHg, −2.71 mmHg and −3.13 mmHg; (2) Angle Closure Glaucoma at 6, 12 and 24 months, respectively: −6.81 mmHg, −7.03 mmHg and −6.52 mmHg; (3) Pseudoexfoliation Glaucoma at 12 months: −5.30 mmHg; (4) Ocular Hypertension at 24 months: −2.27 mmHg. Conclusions: Despite a certain variability, the reduction in ocular pressure was statistically significant at 6, 12 and 24 months in both Open Angle Glaucoma and Angle Closure Glaucoma, the latter being superior. Data for Pseudoexfoliation Glaucoma and for Ocular Hypertension are available, respectively, only at 12 months and at 24 months, both being significant.

Keywords

• glaucoma
• phacoemulsification
• ocular hypertension
• pseudoexfoliation
• open angle glaucoma
• angle closure glaucoma