Original Article October 30, 2024 October 30, 2024

Surgical correction of presbyopia in patients with cataracts and open-angle glaucoma

DOI: 10.37039/1982.8551.20240061

ABSTRACT

Objective:

To evaluate the long-term clinical and refractive results of surgical correction of presbyopia in patients with cataracts and initial to moderate open-angle glaucoma through combined phacoemulsification surgery with multifocal intraocular lens implantation and angular surgery with trabecular implant.

Methods:

This is a real-world retrospective longitudinal study of a series of cases undergoing combined cataract surgery and anti-glaucoma surgery with a second-generation trabecular implant, iStent inject® (Glaukos Inc., California, USA). A statistical analysis of the entire study population was carried out, in addition to a comparative assessment of the eyes according to the type of IOL, categorized into monofocal (Monofocal Group) and multifocal (Multifocal Group).

Results:

214 eyes were identified. The average follow-up time was 38.4 months. The mean preoperative IOP was 16.0 mmHg and at the end of follow-up it was 13.6 mmHg. (p<0.001). At the end of follow-up, 75.7% of eyes had IOP < 18 mmHg, without the need for glaucoma medications. In both groups, between the preoperative period and the end of follow-up, there was a significant improvement in visual acuity and spherical equivalent; however, the proportion of spectacle independence was significantly higher in the group that underwent multifocal IOL.

Conclusion:

An improvement in visual acuity and a high proportion of spectacle independence were observed in the Multifocal Group. In parallel with the improvement in visual capacity, a significant improvement in glaucoma control parameters was observed (reduction in IOP and the amount of ocular hypotensive medications).