Long-term effects of phacoemulsification with intraocular lens implantation in normotensive and ocular hypertensive eyes

PURPOSE: To evaluate the long-term effect of phacoemulsification with intraocular lens (IOL) implantation alone in normotensive and ocular hypertensive eyes. SETTING: Private practices, Minneapolis, Minnesota, and Savannah, Georgia, USA. METHODS: The IOP before surgery, 1 year after surgery, and at the final chart recording in 588 eyes having phacoemulsification with IOL implantation was retrospectively reviewed. Before surgery, eyes were divided into 5 groups based on IOP at surgery, patient age at surgery, years of postoperative follow-up, and a comparison between IOP at 1 year and IOP at the final check. RESULTS: The final mean IOP reduction was 6.5 mm Hg (27%) in the 31 to 23 mm Hg presurgical IOP group (n = 19), 4.8 mm Hg (22%) in the 22 to 20 mm Hg group (n = 62), 2.5 mm Hg (14%) in the 19 to 18 mm Hg group (n = 86), and 1.6 mm Hg (9%) in the 17 to 15 mm Hg group (n = 223). In the 14 to 9 mm Hg group (n = 198), the mean IOP at the final examination was 0.2 mm Hg higher (0.1% increase). CONCLUSIONS: Stratifying eyes according to presurgical IOP showed greater long-term IOP reductions than previously reported. The reduction was proportional to the presurgical IOP. The decrease was greatest in eyes with the highest presurgical IOP. The IOP remained unchanged in eyes with the lowest presurgical IOP. The IOP reductions at 1 year were sustained over 10 years and were similar in patients of all ages.