The effect of combined phacoemulsification and endo-cyclophotocoagulation on intraocular pressure fluctuation assessed by the water drinking test in patients with primary open angle glaucoma
Introduction: The aim of this study was to assess the effect of phacoemulsification and endo-cyclophotocoagulation (phaco-ECP) on intraocular pressure (IOP) fluctuation as assessed by the water drinking test (WDT) in primary open angle glaucoma (POAG). Methods: This was a prospective observatio...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Published: |
Karger Publishers
2023
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| Online Access: | http://psasir.upm.edu.my/id/eprint/108996/ |
| _version_ | 1848865257434382336 |
|---|---|
| author | Mohammad Razali, Amirah Tang, Seng Fai Syed Zakaria, Syed Zulkifli Che-Hamzah, Jemaima Aung, Tin Othman, Othmaliza Md Din, Norshamsiah |
| author_facet | Mohammad Razali, Amirah Tang, Seng Fai Syed Zakaria, Syed Zulkifli Che-Hamzah, Jemaima Aung, Tin Othman, Othmaliza Md Din, Norshamsiah |
| author_sort | Mohammad Razali, Amirah |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | Introduction: The aim of this study was to assess the effect
of phacoemulsification and endo-cyclophotocoagulation
(phaco-ECP) on intraocular pressure (IOP) fluctuation as
assessed by the water drinking test (WDT) in primary open
angle glaucoma (POAG). Methods: This was a prospective
observational study carried out at a tertiary referral centre.
POAG patients on topical antiglaucoma medications and
planned for phaco-ECP were recruited. WDT was performed
before surgery and 6 weeks postoperatively by drinking
10 mL/kg of water in 5 min followed by serial IOP by
Goldmann applanation tonometry measurements at 15, 30,
45, and 60 min. Mean IOP, IOP fluctuation (difference between highest and lowest IOP), IOP reduction, and factors
affecting IOP fluctuation were analysed. Results: Twenty eyes
from 17 patients were included. Baseline IOP was similar
before (14.7 ± 2.7 mm Hg) and after (14.8 ± 3.4 mm Hg, p =
0.90) surgery. There was no difference in mean IOP (17.6 ±
3.4 mm Hg vs. 19.3 ± 4.7 mm Hg pre- and postoperative,
respectively, p = 0.26) or peak IOP (19.37 ± 3.74 mm Hg vs.
21.23 ± 5.29 mm Hg, p = 0.25), albeit a significant reduction in
IOP-lowering medications (2.2 ± 1.15 vs. 0.35 ± 0.93, p < 0.001)
postoperatively. IOP fluctuation was significantly greater
(6.4 ± 3.2 mm Hg vs. 4.6 ± 2.1 mm Hg, p = 0.015) with more
eyes having significant IOP fluctuation of ≥6 mm Hg (11 eyes
[55%] vs. 4 eyes [20%], p < 0.001) postoperatively. Factors that
were significantly associated with increased postoperative
IOP fluctuations were higher preoperative IOP fluctuation (β =
0.69, 95% CI 0.379–1.582, p = 0.004) and more number of
postoperative antiglaucoma medications (β = 0.627, 95% CI
0.614–3.322, p = 0.008). Conclusion: Reducing aqueous
production with phaco-ECP does not eliminate IOP fluctuation in POAG patients. The increase in postoperative IOP
fluctuation suggests increased outflow resistance after
phaco-ECP. |
| first_indexed | 2025-11-15T14:01:50Z |
| format | Article |
| id | upm-108996 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-15T14:01:50Z |
| publishDate | 2023 |
| publisher | Karger Publishers |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-1089962024-10-14T07:02:18Z http://psasir.upm.edu.my/id/eprint/108996/ The effect of combined phacoemulsification and endo-cyclophotocoagulation on intraocular pressure fluctuation assessed by the water drinking test in patients with primary open angle glaucoma Mohammad Razali, Amirah Tang, Seng Fai Syed Zakaria, Syed Zulkifli Che-Hamzah, Jemaima Aung, Tin Othman, Othmaliza Md Din, Norshamsiah Introduction: The aim of this study was to assess the effect of phacoemulsification and endo-cyclophotocoagulation (phaco-ECP) on intraocular pressure (IOP) fluctuation as assessed by the water drinking test (WDT) in primary open angle glaucoma (POAG). Methods: This was a prospective observational study carried out at a tertiary referral centre. POAG patients on topical antiglaucoma medications and planned for phaco-ECP were recruited. WDT was performed before surgery and 6 weeks postoperatively by drinking 10 mL/kg of water in 5 min followed by serial IOP by Goldmann applanation tonometry measurements at 15, 30, 45, and 60 min. Mean IOP, IOP fluctuation (difference between highest and lowest IOP), IOP reduction, and factors affecting IOP fluctuation were analysed. Results: Twenty eyes from 17 patients were included. Baseline IOP was similar before (14.7 ± 2.7 mm Hg) and after (14.8 ± 3.4 mm Hg, p = 0.90) surgery. There was no difference in mean IOP (17.6 ± 3.4 mm Hg vs. 19.3 ± 4.7 mm Hg pre- and postoperative, respectively, p = 0.26) or peak IOP (19.37 ± 3.74 mm Hg vs. 21.23 ± 5.29 mm Hg, p = 0.25), albeit a significant reduction in IOP-lowering medications (2.2 ± 1.15 vs. 0.35 ± 0.93, p < 0.001) postoperatively. IOP fluctuation was significantly greater (6.4 ± 3.2 mm Hg vs. 4.6 ± 2.1 mm Hg, p = 0.015) with more eyes having significant IOP fluctuation of ≥6 mm Hg (11 eyes [55%] vs. 4 eyes [20%], p < 0.001) postoperatively. Factors that were significantly associated with increased postoperative IOP fluctuations were higher preoperative IOP fluctuation (β = 0.69, 95% CI 0.379–1.582, p = 0.004) and more number of postoperative antiglaucoma medications (β = 0.627, 95% CI 0.614–3.322, p = 0.008). Conclusion: Reducing aqueous production with phaco-ECP does not eliminate IOP fluctuation in POAG patients. The increase in postoperative IOP fluctuation suggests increased outflow resistance after phaco-ECP. Karger Publishers 2023-03-14 Article PeerReviewed Mohammad Razali, Amirah and Tang, Seng Fai and Syed Zakaria, Syed Zulkifli and Che-Hamzah, Jemaima and Aung, Tin and Othman, Othmaliza and Md Din, Norshamsiah (2023) The effect of combined phacoemulsification and endo-cyclophotocoagulation on intraocular pressure fluctuation assessed by the water drinking test in patients with primary open angle glaucoma. Ophthalmic Research, 66 (1). pp. 854-861. ISSN 0030-3747; ESSN: 1423-0259 https://karger.com/ore/article/66/1/854/836829/The-Effect-of-Combined-Phacoemulsification-and 10.1159/000530072 |
| spellingShingle | Mohammad Razali, Amirah Tang, Seng Fai Syed Zakaria, Syed Zulkifli Che-Hamzah, Jemaima Aung, Tin Othman, Othmaliza Md Din, Norshamsiah The effect of combined phacoemulsification and endo-cyclophotocoagulation on intraocular pressure fluctuation assessed by the water drinking test in patients with primary open angle glaucoma |
| title | The effect of combined phacoemulsification and endo-cyclophotocoagulation on intraocular pressure fluctuation assessed by the water drinking test in patients with primary open angle glaucoma |
| title_full | The effect of combined phacoemulsification and endo-cyclophotocoagulation on intraocular pressure fluctuation assessed by the water drinking test in patients with primary open angle glaucoma |
| title_fullStr | The effect of combined phacoemulsification and endo-cyclophotocoagulation on intraocular pressure fluctuation assessed by the water drinking test in patients with primary open angle glaucoma |
| title_full_unstemmed | The effect of combined phacoemulsification and endo-cyclophotocoagulation on intraocular pressure fluctuation assessed by the water drinking test in patients with primary open angle glaucoma |
| title_short | The effect of combined phacoemulsification and endo-cyclophotocoagulation on intraocular pressure fluctuation assessed by the water drinking test in patients with primary open angle glaucoma |
| title_sort | effect of combined phacoemulsification and endo-cyclophotocoagulation on intraocular pressure fluctuation assessed by the water drinking test in patients with primary open angle glaucoma |
| url | http://psasir.upm.edu.my/id/eprint/108996/ http://psasir.upm.edu.my/id/eprint/108996/ http://psasir.upm.edu.my/id/eprint/108996/ |