Long-term intraocular pressure changes after femtosecond laser–assisted cataract surgery in healthy eyes and glaucomatous eyes

Purpose: To examine the long-term effect of femtosecond laser–assisted cataract surgery on intraocular pressure (IOP) in healthy (control) and glaucomatous eyes. Setting: University of Colorado, Aurora, Colorado, and Vanderbilt University, Nashville, Tennessee, USA. Design: Retrospective case series. Methods: The study comprised patients aged 18 to 89 years meeting the inclusion criteria. Combination procedures were excluded. The main outcome measure was the change in the mean IOP from baseline to postoperatively. Results: Of the 504 eyes meeting the criteria, 278 were in the glaucoma/glaucoma suspect group and 226 in the control group. Both groups had an initial mean increase in IOP 1 day postoperatively (control: +2.0 mm Hg; 95% confidence interval [CI], 1.4-2.6; glaucoma/glaucoma suspect: +3.4 mm Hg; 95% CI, 2.5-4.2) (both P <.001). The increase was significantly higher in the glaucoma/glaucoma suspect group. The IOP returned to baseline levels at 1 week. At 1 month, both groups had a significant decrease in IOP that persisted until year 1 in the control group and through 3 years in the glaucoma group. The number of IOP medications was unchanged in the glaucoma group during follow-up. The glaucoma/glaucoma suspect group achieved significantly greater IOP lowering than the control group after 6 months. Conclusions: Control eyes and eyes with glaucoma had an initial mean IOP rise 1 day after femtosecond laser–assisted cataract surgery. This was followed by a significant decrease starting at 1 month. The reduction was sustained through 3 years in the glaucoma group.