The reduction of intraocular pressure after phacoemulsification for cataract removal has been reported since the 1990s.
Many studies have shown that cataract removal by phacoemulsification is an effective treatment for hypertension and glaucoma in many patients.
The mean reduction in pressure was up to 3 mmHg in subjects with hypertonia and suspected glaucoma and, more importantly, phacoemulsification alone not only reduced pressure but also reduced medication in subjects with glaucoma.
A greater reduction in pressure was observed in people with higher intraocular pressure before surgery. Reductions in intraocular pressure of up to 10 mmHg have been reported in individuals with preoperative measurements of 25-30 mmHg.
Large reductions in pressure were also observed in people with narrow anterior chamber angles before surgery, perhaps due to age-related lens thickening.
This thickening occurs after the age of 24 years and has been demonstrated by imaging of the eyes. The increasing thickness of the lens pushes the iris forward and narrows the angle of the anterior chamber, resulting in an increase in intraocular pressure. So after cataract surgery, having removed the lens while creating «space» by inserting the thin intraocular lens, we theoretically restore a smoother aqueous humor flow, which consequently leads to a decrease in intraocular pressure.
In measurements performed in subjects with narrow angle or chronic closed-angle glaucoma, we had a decrease in intraocular pressure, with preoperative measurements above 20 mmHg, of 5.2 mmHg, a decrease of 23% compared to all subjects with normal angles, where the decrease was approximately 3.2 mmHg, a decrease of 19%.
Also, in studies of people with pseudoapoptosis or pseudoapoptotic glaucoma, the reduction in pressure after surgery
cataract with phacoemulsification was 1-2 mmHg and was maintained for several years.
Many factors must be taken into account for the best possible surgical treatment of patients with cataract and glaucoma.
Phacoemulsification alone certainly offers another weapon to reduce intraocular pressure and control glaucoma.
