Glaucoma and Intraocular Pressure in Patients Operated for Late In-the-bag Intraocular Lens Dislocation: A Randomized Clinical Trial

作者：Kristianslund Olav^*; Raen Marianne; Ostern Atle Einar; Drolsum Liv

来源：American Journal of Ophthalmology, 2017, 176: 219-227.

DOI：10.1016/j.ajo.2017.01.026

PURPOSE: To compare intraocular pressure (TOP) and IOP-lowering treatment requirements in patients with late in-the-bag intraocular lens (IOL) dislocation operated with 2 different methods, and to assess whether an RN decrease after surgery can be expected.
DESIGN: Prospective, randomized, parallel-group clinical trial.
METHODS: In our university clinic, 104 patients (eyes) were randomly assigned to IOL repositioning by scleral suturing (n = 54) or IOL exchange with a retropupillar iris-claw lens (n = 50). The main outcome measure was 6-month postoperative IOP change.
RESULTS: Overall IOP was 18.0 +/- 6.2 mm Hg before surgery and 15.7 +/- 4.8 mm Hg 6 months after surgery (P < .001). IOP changed by 1.2 +/- 5.8 mm Hg (P =.18) in the Repositioning group and 3.8 +/- 6.4 mm Hg (P < .001) in the Exchange group (group difference: P = .05). Before surgery, 62 patients had either preexisting glaucoma (n = 39) or high IOP (22 mm Hg) with suspected glaucoma (n = 23), of whom several required preoperative IOP-lowering treatment. In the postoperative period, 28% and 21% of the patients in each operation group, respectively, required IOP-lowering treatment with glaucoma medications added, adjunctive laser trabeculoplasty, cyclodiode laser, or filtering surgery. Only 0 and 3 patients, respectively, discontinued their IOP-lowering medication.
CONCLUSIONS: This trial showed an IOP decrease after late in-the-bag IOL dislocation surgery that seemed to be more pronounced with IOL exchange. However, associated high IOP was not resolved by dislocation surgery in many patients, and increased IOP-lowering treatment in the postoperative course was commonly required.

• 出版日期2017-4