Effect of phacoemulsification on intraocular pressure in normal and glaucomatous eyes

Background: Cataract and glaucoma are the leading causes of blindness globally, with prevalence increasing with age. Many glaucoma patients develop cataracts, either naturally or as a result of treatment. Cataract extraction in glaucoma patients may not only improve vision but also help reduce intraocular pressure (IOP), particularly in resource-limited settings such as Nepal, where follow-up for traditional glaucoma surgeries is challenging. Aims and Objectives: To compare pre-operative and post-operative IOP following phacoemulsification surgery in normal eyes and those with medically controlled primary open-angle glaucoma (POAG). Materials and Methods: A hospital-based prospective observational study was conducted from November 2016 to March 2018, enrolling 61 patients – 31 in the cataract group and 30 in the POAG with cataract group. Visual acuity, IOP, and use of anti-glaucoma medications were assessed preoperatively and at 1 day, 1 week, 1 month, and 3 months postoperatively. Data were analyzed using the Statistical Package for the Social Sciences v20, with statistical significance set at P<0.05. Results: The mean age among males was 58.76±10.2 years standard deviation and 63.31±7.92 years in the cataract and POAG and cataract group, respectively. The mean age among females was 64.79±10.06 years and 63.06±8.75 years in cataract and POAG. In the POAG group, mean IOP reduced from 18.27±3.50 mmHg to 15.27±2.13 mmHg (P < 0.001). In the cataract-only group, IOP decreased from 18.32±2.55 mmHg to 17.39±2.03 mmHg (P = 0.001). The combined group analysis showed a significant overall IOP reduction from 18.30±3.03 mmHg to 16.34±2.32 mmHg (P<0.001). Conclusion: Phacoemulsification surgery significantly reduces IOP in both cataract-only patients and those with medically controlled POAG, suggesting a dual benefit of visual restoration and IOP control.