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Abstract
Purpose
To determine the effect of cataract extraction on visual field damage in glaucoma patients with cataracts.
Methods
Sixty-two eyes of fifty glaucoma patients (primary open-angle glaucoma, angle-closure glaucoma, and normal-tension glaucoma) were divided into three groups according to the MD (mean deviation) value from the Humphrey automatic visual field test. The PSD (pattern standard deviation) values were analyzed before and after the cataract surgery. Additionally, the visual acuity, intraocular pressure and the number of antiglaucomatous agents were compared.
Results
All of the three groups, showed significant improvement in visual acuity. However, there was only a significant decrease in intraocular pressure at three months postoperatively. When comparing the mean MD values of each group, there was a statistically significant difference between the mild defect group and the severe defect group, but no statistically significant difference in the moderate defect group. There was also no statistically significant difference in PSD values in the any of the groups before and after cataract surgeries.
Conclusions
In glaucoma patients with cataracts, there were no significant differences in PSD values before and after cataract surgery. Additionally, to perform an adequate cataract operation in advanced glaucoma patients without the progression of visual field damage, lowering intraocular pressure and improving visual acuity is helpful.
References
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Table 1.
Patients demographics
| | Mild defect G | Moderate defect G | Severe defect G | p-value |
|---|---|---|---|---|
| Number of eyes | 22 | 20 | 20 | |
| Age (year, M± SD) | 75.00±8.22 | 71.10±11.42 | 76.80±7.33 | 0.138* |
| Gender (male/female) | 6/18 | 9/11 | 7/13 | 0.486† |
| Type of glaucoma | | | | |
| POAG, n (%) | 0 (0%) | 2 (10%) | 3 (15%) | 0.189† |
| NTG, n (%) | 18 (82%) | 14 (70%) | 14 (70%) | 0.596† |
| ACG, n (%) | 4 (18%) | 4 (20%) | 3 (15%) | 0.916† |
| ALPI procedure | 4 | 2 | 4 | 0.655† |
| Systemic disease | | | | |
| DM | 4 | 4 | 2 | 0.655† |
| HTN | 12 | 11 | 8 | 0.554† |
| Follow‐up (month, M± SD) | 18.18±10.35 | 23.95±17.83 | 22.70±16.05 | 0.771* |
Table 2.
Comparison of best-corrected visual acuity, intraocular pressure, mean deviation, pattern standard deviation and number of medication in mild defect group
| IOP |
montd |
IOP (mm Hg)(Mean± SD) |
Range (mmHg) |
Change in IOP (mmHg)(Mean± SD) |
p-value |
| Preop. | 12.76±3.13 | 8∼17 | | | |
| Postop. | | | | | |
| 1 | 11.36±2.47 | 6∼15 | −1.40±2.23 | 0.015* | |
| 3 | 11.36±2.05 | 8∼15 | −1.40±2.84 | 0.024* | |
| 6 | 11.09±1.77 | 7∼14 | −1.67±3.38 | 0.03* | |
| Best corrected V/A (LogMAR) |
montd |
V/A (Mean±SD) |
Range |
Change in V/A (Mean±SD) |
p-value |
| Preop. Postop.1 | 0.65±0.34 | 0.3∼1.3 | | | |
| 1 | 0.23±0.13 | 0.3∼1.0 | −0.41±0.32 | <0.001* | |
| 3 | 0.19±0.19 | 0∼0.7 | −0.45±0.24 | <0.001* | |
| 6 | 0.13±0.15 | 0∼0.5 | −0.51±0.24 | <0.001* | |
| MD |
|
MD (dB)(Mean± SD) |
Range (dB) |
Change in MD (Mean±SD) |
p-value |
| Preop. MD | −3.42±1.25 | −4.98∼-1.32 | | | |
| Postop. | −2.88±1.26 | −5.24∼-0.78 | 0.65±1.27 | 0.025* | |
| PSD |
|
PSD (dB)(Mean± SD) |
Range (dB) |
Change in PSD (Mean±SD) |
p-value |
| Preop. | 2.92±1.60 | 1.95∼7.55 | | | |
| Postop. | 2.83±1.18 | 1.50∼5.02 | −0.18±1.15 | 0.477* | |
| Number of medication |
|
Number (Mean±SD) |
Range |
Change in number (Mean±SD) |
p-value |
| Preop. | 1.42±0.75 | 1∼3 | | | |
| Postop. | 1.14±0.36 | 1∼2 | −0.30±0.27 | 0.499* |
Table 3.
Comparison of best-corrected visual acuity, intraocular pressure, mean deviation, pattern standard deviation and number of medication in moderate defect group
| IOP |
montd |
IOP (mm Hg)(Mean± SD) |
Range (mmHg) |
Change in IOP (mmHg)(Mean± SD) |
p-value |
| Preop. | 13.75±3.20 | 9∼19 | | | |
| Postop. IOP | | | | | |
| 1 | 12.90±3.46 | 7∼20 | −0.85±2.60 | 0.107* | |
| 3 | 12.30±2.43 | 8∼20 | −1.45±2.91 | 0.033* | |
| 6 | 13.30±2.83 | 8∼20 | −0.45±2.94 | 0.455* | |
| Best corrected VA (LogMAR) |
montd |
V/A (Mean±SD) |
Range |
Change in V/A (Mean±SD) |
p-value |
| Preop. | 0.63±0.40 | 0.2∼1.3 | | | |
| Postop. | | | | | |
| 1 | 0.26±0.28 | 0∼1.3 | −0.37±0.28 | <0.001* | |
| 3 | 0.21±0.29 | 0∼1.3 | −0.42±0.31 | <0.001* | |
| 6 | 0.20±0.28 | 0∼1.3 | −0.43±0.33 | <0.001* | |
| MD |
|
MD (dB)(Mean± SD) |
Range (dB) |
Change in MD (dB)(Mean± SD) |
p-value |
| Preop. | −7.48±2.11 | −10.87∼-5.57 | | | |
| Postop. | −7.21±2.30 | −10.57∼-2.46 | 0.27±2.41 | 0.852* | |
| PSD |
|
PSD (dB)(Mean± SD) |
Range (dB) |
Change in PSD (dB)(Mean± SD) |
p-value |
| Preop. | 4.35±1.93 | 1.97∼9.93 | | | |
| Postop. | 5.07±2.61 | 1.79∼9.98 | 4.35±1.93 | 0.135* | |
| Number of medication |
|
Number (Mean±SD) |
Range |
Change in Number (Mean±SD) |
p-value |
| Preop. | 1.28±0.75 | 1∼4 | | | |
| Postop. | 1.22±0.93 | 1∼3 | −0.05±0.23 | 0.238* |
Table 4.
Comparison of best-corrected visual acuity, intraocular pressure, mean deviation, pattern standard deviation and number of medication in severe defect group
| IOP |
montd |
IOP (mmHg)(Mean± SD) |
Range (mmHg) |
Change in IOP (mmHg)(Mean± SD) |
p-value |
| Preop. | 14.31±2.95 | 10∼21 | | | |
| Postop. | | | | | |
| 1 | 11.40±3.84 | 7∼23 | −2.91±4.05 | 0.008* | |
| 3 | 11.00±2.10 | 7∼15 | −3.31±3.31 | 0.001* | |
| 6 | 11.80±2.72 | 7∼17 | −2.51±2.92 | 0.001* | |
| Best corrected VA (LogMAR) |
montd |
V/A (Mean±SD) |
Range |
Change in V/A (Mean±SD) |
p-value |
| Preop. | 0.71±0.32 | 0.30∼1.30 | | | |
| Postop. | | | | | |
| 1 | 0.35±0.21 | 0.05∼0.8 | −0.35±0.40 | 0.002* | |
| 3 | 0.35±0.21 | 0.05∼1.0 | −0.39±0.41 | 0.001* | |
| 6 | 0.34±0.29 | 0∼1.0 | −0.37±0.46 | 0.004* | |
| MD | | MD (dB)(Mean± SD) | Range (dB) | Change in MD (dB)(Mean± SD) | p-value |
| Preop. | −18.96±5.41 | −29.16∼12.11 | | | |
| Postop. | −16.51±7.99 | −29.39∼-6.05 | 2.44±4.62 | 0.04* | |
| PSD |
|
PSD (dB) (Mean± SD) |
Range (dB) |
Change in PSD (dB)(Mean± SD) |
p-value |
| Preop. | 7.55±2.34 | 2.95∼12.08 | | | |
| Postop. | 7.89±2.19 | 2.62∼12.58 | 0.33±2.09 | 0.538* | |
| Number of medication |
|
Number (Mean±SD) |
Range |
Change in number (Mean±SD) |
p-value |
| Preop. | 1.83±0.85 | 0∼4 | | | |
| Postop. | 1.82±0.89 | 0∼3 | −0.02±0.12 | 0.92* |
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