In the ongoing investigation into understanding and predicting changes to intraocular pressure (IOP), one more clue has now been uncovered. Gonioscopy scores can operate as a clinical predictor for IOP reduction after cataract surgery, according to researchers from the University of California. The team’s study looked at consecutive patients with or without glaucoma—either with open or narrow angles, but without peripheral anterior synechiae—who underwent phacoemulsification. The researchers found that the mean IOP reduction after phaco for these patients was 3mm Hg (±2.6mm Hg) six months after surgery.

In addition to gonioscopy scores, the study also determined that preoperative predictors for IOP reduction after cataract surgery include anterior chamber depth (ACD) and the IOP/ACD ratio.

“For the practicing clinician, it would be helpful to have a more readily available parameter or score that can help predict IOP reduction after surgery. Since angle status has been shown in some studies to correlate with this reduction, gonioscopy values may provide clinically accessible predictors for treating clinicians,” the report explains.

The team looked at 188 eyes (from 137 patients). The mean age for these patients was 75 and the average preoperative IOP was 15.6mm Hg (±3.6mmHg). After multivariate analysis, pre-op IOP gonioscopy score, ACD and IOP/ACD ratio were associated with IOP reduction at six months.

Perez C, Chansangpetch S, Feinstein M, et al. Novel gonioscopy score and predictive factors for intraocular pressure lowering after phacoemulsification. J Glaucoma. 2018 May 4. [Epub ahead of print].