Journal d'ophtalmologie clinique et expérimentale
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Effects of Cataract Extraction on the Outcomes of Automated Perimetry and Retinal Nerve Fiber Layer Thickness Measurements by Optical Coherence Tomography in Primary Angle Closure Glaucoma

Xiaofei Man, Noel CY Chan, Tiffany WS Lau, and Clement C Tham

Objective: To evaluate the effect of cataract extraction on both visual field and retinal nerve fiber layer thickness measurements in primary angle closure glaucoma (PACG) eyes.
Methods: Retrospective cohort study on 30 PACG eyes underwent cataract extraction. Changes in RNFL thickness and visual field parameters including mean deviation (MD), visual field index (VFI) and pattern standard deviation (PSD) were analyzed within 6 months before and after cataract extraction.
Results: Overall, MD (p=0.003) and VFI (p=0.004) improved significantly after cataract extraction, whereas PSD showed no significant change (p=0.6). In the 10 eyes with MD worse than -20 dB, mean MD improved by 3.4 ± 3.56 dB (from -24.36 ± 3.06 dB to -20.96 ± 5.06 dB, p=0.01) and mean VFI improved by 16.25 ± 15.66% (from 23.38 ± 9.65% to 39.63 ± 20.83%, p=0.02). PSD showed no significant change after cataract extraction (p=0.07). In the 20 eyes with MD better than -20 dB, MD and VFI also improved postoperatively, but the changes did not reach statistical significance: mean MD improved by 1.64 ± 3.65 dB (from -11.57 ± 5.57 dB to -9.92 ± 5.36 dB, p=0.05) whilst mean VFI improved by 4.57 ± 12.29% (from 74.95 ± 17.95% to 79.52 ± 17.26%, p=0.07). RNFL thickness did not show any significant changes after cataract extraction (p=0.13).
Conclusions: Both MD and VFI improved after cataract extraction, especially in eyes with pre-operative MD worse than -20 dB. PSD and RNFL thickness showed no significant change after cataract extraction.