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Cataract Surgery Outcomes in Glaucomatous Eyes: Results From the Veterans Affairs Ophthalmic Surgery Outcomes Data Project.
Am J Ophthalmol. 2015 Oct; 160(4):693-701.e1.AJ

Abstract

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.

Authors+Show Affiliations

Ophthalmology Department, Veterans Affairs Boston Healthcare System, Jamaica Plains, Massachusetts; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.Ophthalmology Department, Veterans Affairs Boston Healthcare System, Jamaica Plains, Massachusetts; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.Ophthalmology Department, Veterans Affairs Boston Healthcare System, Jamaica Plains, Massachusetts.Ophthalmology Department, Veterans Affairs Boston Healthcare System, Jamaica Plains, Massachusetts.Veterans Affairs Tennessee Valley Healthcare System Center, Nashville, Tennessee; Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee.St Louis Veterans Affairs Healthcare System, Saint Louis, Missouri; Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, Saint Louis, Missouri.Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.Department of Defense/Veterans Affairs Vision Center of Excellence, Bethesda, Maryland.Ophthalmology Department, Veterans Affairs Boston Healthcare System, Jamaica Plains, Massachusetts; Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts. Electronic address: mary.daly2@va.gov.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26210863

Citation

Turalba, Angela, et al. "Cataract Surgery Outcomes in Glaucomatous Eyes: Results From the Veterans Affairs Ophthalmic Surgery Outcomes Data Project." American Journal of Ophthalmology, vol. 160, no. 4, 2015, pp. 693-701.e1.
Turalba A, Payal AR, Gonzalez-Gonzalez LA, et al. Cataract Surgery Outcomes in Glaucomatous Eyes: Results From the Veterans Affairs Ophthalmic Surgery Outcomes Data Project. Am J Ophthalmol. 2015;160(4):693-701.e1.
Turalba, A., Payal, A. R., Gonzalez-Gonzalez, L. A., Cakiner-Egilmez, T., Chomsky, A. S., Vollman, D. E., Baze, E. F., Lawrence, M., & Daly, M. K. (2015). Cataract Surgery Outcomes in Glaucomatous Eyes: Results From the Veterans Affairs Ophthalmic Surgery Outcomes Data Project. American Journal of Ophthalmology, 160(4), 693-e1. https://doi.org/10.1016/j.ajo.2015.07.020
Turalba A, et al. Cataract Surgery Outcomes in Glaucomatous Eyes: Results From the Veterans Affairs Ophthalmic Surgery Outcomes Data Project. Am J Ophthalmol. 2015;160(4):693-701.e1. PubMed PMID: 26210863.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cataract Surgery Outcomes in Glaucomatous Eyes: 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, Y1 - 2015/07/22/ PY - 2015/05/02/received PY - 2015/07/14/revised PY - 2015/07/15/accepted PY - 2015/7/27/entrez PY - 2015/7/27/pubmed PY - 2015/12/15/medline SP - 693 EP - 701.e1 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 160 IS - 4 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. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/26210863/Cataract_Surgery_Outcomes_in_Glaucomatous_Eyes:_Results_From_the_Veterans_Affairs_Ophthalmic_Surgery_Outcomes_Data_Project_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(15)00444-4 DB - PRIME DP - Unbound Medicine ER -