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Abstract
Purpose
We evaluated the short and long-term changes of intraocular pressure (IOP) and studied its risk factors in pseudoexfoliation (PEX).
Methods
A total of 40 eyes that had been newly diagnosed with PEX from January 1, 1995 to December 31, 2007 were included in this study. Age, gender and accompanying systemic disease were recorded. In addition, the age, gender, number of antiglaucoma eye drops, history of cataract operation, and history of systemic disease were evaluated as risk factors for IOP elevation during the follow-up periods. Pre and post cataract operation IOP was checked to evaluate the effect of the cataract operation on IOP.
Results
The risk factors for IOP elevation in patients newly diagnosed with PEX were old age and female gender. After treatment, a long follow-up period and number of eyedrops were risk factors for IOP elevation. The cataract operation had a one year IOP control effect, especially in cases where the pre operative IOP was greater than 21 mmHg. Over the long term, however, the IOP control effect of cataract surgery could not be determined.
References
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Table 1.
The characteristics of patients newly diagnosed with psuedoexfoliation syndrome
| IOP | IOP | |
|---|---|---|
| Over 21 mmHg | same or under 21 mmHg | |
| Number of patients (%) | 14 (35.0%) | 26 (65.0%) |
| Average IOP | ||
| (range) | 27.2±4.5* | 18.2±5.6* |
| (mmHg) | (23∼37) | (11∼20) |
| Age | 73.5±10.2† | 64.52±9.5† |
| (years) | (63∼88) | (52∼64) |
| Gender | M:F=3:18‡ | M:F=11:8‡ |
| Diabetes Mellitus | 2 | 2 |
| Hypertension | 13 | 12 |
| Cardio-vascular disease | 0 | 2* |
Table 2.
Comparing the characteristics of patients in between IOP elevation group and control group during follow-up periods
| IOP elevation | Control group | |
|---|---|---|
| Number of patients (%) | 15 (37.5%) | 25 (62.5%) |
| Age | 76.5±8.5* | 68.2±9.9* |
| Gender | M:F=1:14† | M:F=13:12† |
| Number of eyedrops (before IOP elevation) | 1.1±0.6‡ | 0.8±0.5‡ |
| Number of eyedrops (last follow-up) | 1.9±0.5§ | 0.9±0.5§ |
| Cataractoperation | Yes:no=2:13П | Yes:no=17:8П |
| Diabetes mellitus | 1 | 3 |
| Hypertension | 14 | 11 |
| Cardiovascular disease | 1 | 3 |
| Follow-up duration (years) | 7.9±3.9# | 5.6±4.4# |
# Fisher's exact test, P<0.01; The numbers of diabetes mellitus and cardiovascular diseases were so small, we could not perform the statistic analysis. There was no significant difference between two groups in hypertensive patients. Notice: In case of cardiovascular disease, all 2 cases had diabetes mellitus simultaneously.
Table 3.
The changes of intraocular pressure (IOP) and number of antiglaucoma eye drops before and after cataract operation
| IOP same or under 21 mmHg | IOP over 21 mmHg | Average | ||||||
|---|---|---|---|---|---|---|---|---|
| IOP | Number of antiglaucoma eye drops | Number of eye | IOP | Number of antiglaucoma eye drops | Number of eyes (number of eye drops-used eyes) | IOP | Number of antiglaucoma eye drops | |
| Pre-operation | 17.7±2.2 | 1.2±0.4 | n=10 | 24.3±1.6 | 1.20±0.42* | n=14 (n=10) | 21.6±1.8 | 1.23±0.43† |
| POD 1 day | 14.7±1.2 | 1.2±0.4 | n=10 | 17.0±1.2 | 1.20±0.42 | n=14 (n=10) | 16.0±1.4 | 1.23±0.43 |
| POD 1 week | 14.4±1.4 | 1.2±0.4 | n=10 | 16.7±1.8 | 1.20±0.42 | n=14 (n=10) | 15.7±1.5 | 1.23±0.43 |
| POD 1 month | 15.6±1.7 | 1.2±0.4 | n=10 | 16.8±1.6 | 1.20±0.42 | n=14 (n=10) | 16.3±1.5 | 1.23±0.43 |
| POD 2 months | 14.7±1.8 | 1.2±0.4 | n=10 | 16.8±1.4 | 1.20±0.42 | n=14 (n=10) | 15.9±1.7 | 1.23±0.43 |
| POD 6 months | 14.9±1.2 | 0.2±0.4 | n=10 | 16.8±1.8 | 0.8±0.4 | n=12 (n=8) | 16.0±1.3 | 0.7±0.48 |
| POD 1 year | 15.1±3.1‡ | 0.3±0.5§ | n=8 | 17.4±3.3∏ | 0.6±0.4# | n=12 (n=8) | 16.1±1.7* | 0.8±0.4† |
| POD 3 years | 18.3±1.2‡ | 1.0±0.6§ | n=6 | 19.4±1.4∏ | 1.8±1.0# | n=8 (n=7) | 18.4±4.1* | 1.4±0.9† |
| POD 5 years | 18.8±1.3 | 1.8±2.0 | n=4 | 19.3±1.2 | 2.2±2.0 | n=6 (n=5) | 19.1±1.2 | 1.9±1.7 |
| POD 7 years | 18.5±1.7 | 2.3±0.7 | n=3 | 20.3±1.0 | 2.8±1.0 | n=4 (n=4) 1 | 19.57±1.21 | 2.57±0.81 |
＃ statisticallysignificant at the level of P=0.01; IOP=intraocular pressure; POD=postoperative days; n=number of eyes of the patients; The IOP significantly decreased at the first postoperative day compared to pre-operative IOP. The IOP had been kept at the level similar to that of POD 1 day for 1 year (Bold). The number of eye drops decreased after cataract operation and kept similar number up to POD 1 year. Then after POD 3 years, the IOP and the number of eye drops increased. (After cataract operation, the antiglaucoma eye drops were continued in the same manneras pre-cataract operation for 2 months)
Table 4.
The results of multivariate regression test in intraocular pressure elevation group during follow-up periods
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