Refractive Outcomes of Cataract Surgery With or Without Endocyclophotocoagulation.

PRECIS: Surgeons that perform cataract surgery combined with endocyclophotocoagulation (ECP) should rely on their preferred intraocular lens (IOL) calculation formula. There is no need to perform any correction to the IOL power, as this procedure does not modify the refractive outcome. PURPOSE: The purpose of this study was to compare postoperative refractive outcomes in patients with glaucoma who underwent phacoemulsification and IOL implantation with or without ECP and the change in intraocular pressure (IOP) and number of antiglaucoma medications between groups. METHODS: A cross-sectional study in which the medical records of the patients with any type of glaucoma, who underwent phacoemulsification with IOL implantation in the capsular bag in addition to ECP or as a standalone procedure from June 2016 to August 2019 were analyzed. Clinical data collected included axial length, steep, flat, and mean keratometry values, target spherical equivalent (SE) estimated by the SRK/T formula, manifest refraction SE at the 1-month follow-up, IOP, and number of antiglaucoma medications before and 12 months after surgery. Primary and secondary outcome measures were the mean predictive error (MPE), the postoperative SE, and the change in IOP after surgery in both groups, respectively. Significance was assessed using the Student t test for all variables between groups according to data distribution. P-values <0.05 were considered to be statistically significant. RESULTS: A total of 196 eyes of 196 patients were included, 98 in the combined phacoemulsification-ECP group, and 98 in the non-ECP group. The observed MPE was -0.043±0.44, and 0.06±0.38 D MPE, respectively (P=0.079). Overall, 74.34% in the phacoemulsification-ECP group and 78.4% in the non-ECP group had a postoperative SE of ±0.50. The ECP group had lower IOP and a greater decrease in antiglaucoma medications at 12 months of follow-up. CONCLUSIONS: SRK/T formula performed well in both groups, with no statistically significant difference in the MPE and the percentage of eyes achieving postoperative SE of ±0.50. We consider it is unnecessary to perform any kind of correction to the IOL power calculation when performing ECP.

Depression and Medical Treatment Adherence in Mexican Patients With Glaucoma.

PRECIS: The prevalence of depression in Mexican patients with glaucoma is higher than that reported in the general population. Depression prevalence and severity are directly associated with glaucoma severity and lower adherence to medical treatment. PURPOSE: To determine the prevalence of depression in patients with glaucoma and to describe the correlation between the severity of depression, glaucoma, and treatment adherence. PATIENTS AND METHODS: This cross-sectional study included 111 patients with glaucoma who answered the Beck Depression Inventory (BDI)-II and the Morisky-Green questionnaire that evaluated their depression severity and medical treatment adherence. Low treatment adherence was defined as having a score of >2 on the Morisky-Green questionnaire. Analysis of variance, Fisher exact test, and linear regression models were used for statistical analyses. The main outcomes were prevalence of depression, prevalence of depression according to glaucoma damage, and the association between depression severity, medical treatment adherence, and glaucoma damage. RESULTS: The average patient age was 67.6±13.8 years. The prevalence of depression was 50.4%. Analysis of variance revealed a statistically significant association between glaucoma severity of the "worse eye" and the BDI raw score. In the "better eye," there was no statistically significant difference in mean BDI raw scores across glaucoma severity categories. There was a statistically significant association between the presence of depression and the level of treatment adherence after adjusting for age, sex, type of glaucoma, and the glaucoma severity in both eyes. The risk of low treatment adherence in patients with depression was 38 times that of patients with no depression. CONCLUSION: Glaucoma is associated with a prevalence of depression nearly 10 times higher than that in the general population. Glaucoma, depression severity, and lower adherence to medical treatment are associated.