Changes in the topography of the anterior segment of the eye and uveoscleral outflow indicators in patients with primary glaucoma during cataract phacoemulsification

PURPOSE: To identify changes in the parameters of the anterior segment of the eye and uveoscleral outflow indicators in patients with primary glaucoma during cataract phacoemulsification surgery. METHODS: The study included 153 patients (153 eyes) with cataract and primary open-angle glaucoma. All patients were divided into three groups: 51 patients (51 eyes) with cataract without glaucoma (first group), 51 patients (51 eyes) with cataract and the initial stage of primary open-angle glaucoma (second group), 51 patients (51 eyes) with cataract and advanced stages of primary open-angle glaucoma (third group). Before and after surgery patients underwent pneumotonometry, tonography with vacuum compression (unit Glau-Test60) and were examined by means of Pentacam anterior segment analyzer (Oculus). All patients underwent cataract phacoemulsification with implantation of a posterior chamber intraocular lens. The observation period duration was 6 months. RESULTS: Cataract phacoemulsification with intraocular lens implantation decreases IOP. More pronounced hypotensive effect can be noted in patients with an advanced stage glaucoma and patients not suffering from glaucoma. Topographic relations of the anterior segment structures undergo more changes after the operation in the eyes of patients with advanced-stage glaucoma. The post-surgical uveoscleral outflow increase in the presence of trabecular outflow block is more expressed in patients with initial stage of glaucoma and in patients without glaucoma. The share of uveoscleral pathway in the intraocular fluid outflow both before and after surgery is prevalent in patients with advanced-stage of glaucoma. CONCLUSION: The hypotensive effect of cataract phacoemulsification in patients with primary glaucoma is due to topographical changes in the structures of the anterior segment of the eye and possibly to increasing uveoscleral outflow of intraocular fluid.

глаукома, увеосклеральный отток, внутриглазное давление, факоэмульсификация катаракты, glaucoma, uveoscleral outflow, intraocular pressure, cataract phacoemulsification

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