Journal of Current Glaucoma Practice

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VOLUME 11 , ISSUE 3 ( September-December, 2017 ) > List of Articles


Long-term Follow-up of Patients receiving Intraocular Pressure-lowering Medications as Cataract Surgery Candidates: A Case—control Study

Georgios Bontzos, Michail Agiorgiotakis, Efstathios T Detorakis

Citation Information : Bontzos G, Agiorgiotakis M, Detorakis ET. Long-term Follow-up of Patients receiving Intraocular Pressure-lowering Medications as Cataract Surgery Candidates: A Case—control Study. J Curr Glaucoma Pract 2017; 11 (3):107-112.

DOI: 10.5005/jp-journals-10028-1234

License: CC BY 3.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2017; The Author(s).



In this study, we reviewed demographics and biometric characteristics among patients receiving chronic β-blockers and prostaglandins (PGs) for primary open-angle glaucoma. We compared the age at the time of cataract surgery in different patient groups and in a control group which was not under any medication.

Materials and methods

Retrospective chart review of glaucomatous patients who underwent cataract extraction at the Department of Ophthalmology of the University Hospital of Heraklion, Crete, Greece, between January 1998 and December 2016 was done. Age at cataract surgery, axial length (AL), and preoperative and postoperative best-corrected visual acuities (BCVAs) were recorded. A cohort of patients without glaucoma who were operated for cataract extraction was also evaluated.


In all, 320 patients were reviewed. There were significant results in mean age difference between the beta-antagonist and the PG group [3.05 years, 95% confidence interval (CI) 1.54-4.57] and between the beta-antagonist group with the patients receiving a combined therapy (3.02 years, 95% CI 1.14-4.91). No significant difference was found between the PG and the combination group. All the three treated groups had a significant lower mean age than the control group at the time of cataract surgery.


Based on our study, we concluded that there might be a possible association between chronic treatment with beta-antagonist agents and earlier cataract surgical time in the treated eye.

Clinical significance

Intraocular pressure control is often usually achieved using ophthalmic agents. Their topical and systemic effects should be monitored precisely. Earlier cataract formation might be an important side effect which the physician has to keep in mind before choosing the suitable medication.

How to cite this article

Bontzos G, Agiorgiotakis M, Detorakis ET. Long-term Follow-up of Patients receiving Intraocular Pressure-lowering Medications as Cataract Surgery Candidates: A Case—control Study. J Curr Glaucoma Pract 2017;11(3):107-112.

  1. Age-related cataract. Lancet. 2005 Feb 12-18;365(9459):599-609.
  2. The Framingham Eye Study monograph: an ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973–1975. Surv Ophthalmol 1980 May-Jun;24(Suppl):335-610.
  3. Prevalence and causes of visual impairment in The Barbados Eye Study. Ophthalmology 2001 Oct;108(10):1751-1756.
  4. Prevalence and risk indicators of visual impairment and blindness in Latinos: the Los Angeles Latino Eye Study. Ophthalmology 2004 Jun;111(6):1132-1140.
  5. Prevalence of vision impairment in older adults in rural China: the China Nine-Province Survey. Ophthalmology 2010 Mar;117(3):409-416, 416.e401.
  6. A population-based eye survey of older adults in a rural district of Rajasthan: I. Central vision impairment, blindness, and cataract surgery. Ophthalmology 2001 Apr;108(4):679-685.
  7. Prevalence and causes of visual impairment and blindness in an urban Indian population: the Singapore Indian eye study. Ophthalmology 2011 Sep;118(9):1798-1804.
  8. Terminology and guidelines for glaucoma. 4th ed. 2014. Available from:
  9. Intraocular pressure-lowering combination therapies with prostaglandin analogues. Drugs 2012 Jul 9;72(10):1355-1371.
  10. Are preservatives necessary to improve efficacy of some glaucoma drops? Br J Ophthalmol 2013 Dec;97(12):1493-1494.
  11. Pharmacotherapy of glaucoma. J Ocul Pharmacol Ther 2015 Mar;31(2):63-77.
  12. Effects of AGN 192024, a new ocular hypotensive agent, on aqueous dynamics. Am J Ophthalmol 2001 Jan;131(1):19-24.
  13. Effects of prostaglandins on the aqueous humor outflow pathways. Surv Ophthalmol 2002 Aug;47 (Suppl 1):S53-S64.
  14. Mechanism of ocular hypotensive action of bimatoprost (Lumigan) in patients with ocular hypertension or glaucoma. Ophthalmology 2004 Sep;111(9):1658-1662.
  15. Mechanism of action of bimatoprost, latanoprost, and travoprost in healthy subjects. A crossover study. Ophthalmology 2008 May;115(5):790-795.e4.
  16. Review: alpha 2 and DA2 agonists as antiglaucoma agents: comparative pharmacology and clinical potential. J Ocul Pharmacol 1990 Fall;6(3):251-257.
  17. Brimonidine: a new alpha2-adrenoreceptor agonist for glaucoma treatment. J Glaucoma 1997 Aug;6(4):250-258.
  18. Cataract formation following vitreoretinal procedures. Clin Ophthalmol 2014 Sep 23;8:1957-1965.
  19. Cataract development and cataract surgery in patients with juvenile rheumatoid arthritis-associated iridocyclitis. Ophthalmology 1993 Jun;100(6):809-817.
  20. Risk factors for cortical, nuclear, and posterior subcapsular cataracts: the POLA study. Pathologies Oculaires Lieesal'Age. Am J Epidemiol 2000 Mar 1;151(5):497-504.
  21. The lens opacities case-control study. Risk factors for cataract. Arch Ophthalmol 1991 Feb;109(2):244-251.
  22. Development of cataract and associated risk factors: the Visual Impairment Project. Arch Ophthalmol 2006 Jan;124(1):79-85.
  23. Risk factors for incident cortical and posterior subcapsular lens opacities in the Barbados Eye Studies. Arch Ophthalmol 2004 Apr;122(4):525-530.
  24. Diabetes, cardiovascular disease, selected cardiovascular disease risk factors, and the 5-year incidence of age-related cataract and progression of lens opacities: the Beaver Dam Eye Study. Am J Ophthalmol 1998 Dec;126(6):782-790.
  25. Influence of diabetes and cardiovascular disease on the long-term incidence of cataract: the Blue Mountains Eye Study. Ophthalmic Epidemiol 2008 Sep-Oct;15(5):317-327.
  26. Use of inhaled corticosteroids and the risk of cataracts. N Engl J Med 1997 Jul 3;337(1):8-14.
  27. Use of inhaled and oral corticosteroids and the long-term risk of cataract. Ophthalmology 2009 Apr;116(4):652-657.
  28. Corticosteroid-induced cataracts. Surv Ophthalmol 1986 Sep-Oct;31(2):102-110.
  29. Axial length and age at cataract surgery. J Cataract Refract Surg 2004 May;30(5):1045-1048.
  30. Cardiovascular effects of timolol maleate, brimonidine or brimonidine/timolol maleate in concomitant therapy. Acta Ophthalmol Scand 2002 Jun;80(3):277-281.
  31. Effects of systemic beta-blocker therapy on the efficacy and safety of topical brimonidine and timolol. Brimonidine Study Groups 1 and 2. Ophthalmology 2000 Jun;107(6):1171-1177.
  32. Chronic open angle glaucoma treated with Timolol. A four year study. Trans Ophthalmol Soc UK 1983;103(Pt 1):78-83.
  33. Long-term topical timolol and blood lipids: the Blue Mountains Eye Study. J Glaucoma 2000 Apr;9(2):174-178.
  34. Effects of topical timolol (0.5%) and betaxolol (0.5%) on corneal sensitivity. Br J Ophthalmol 1990 Jul;74(7):409-412.
  35. Immunohistochemical differences between normal and chronically inflamed conjunctiva: diagnostic features. Am J Dermatopathol 2011 Dec;33(8):786-789.
  36. Morphologic alterations of the palpebral conjunctival epithelium in a dry eye model. Cornea 2013 Apr;32(4):483-490.
  37. Cystoid macular edema associated with latanoprost in aphakic and pseudophakic eyes. Am J Ophthalmol 1998 Oct;126(4):602-604.
  38. Periorbital changes associated with topical bimatoprost. Ophthal Plast Reconstr Surg 2008 Jul-Aug;24(4):302-307.
  39. Expression of prostaglandin receptors EP4 and FP in human lens epithelial cells. Invest Ophthalmol Vis Sci 1999 Jan;40(1):105-112.
  40. Hemodynamic evaluation of the posterior ciliary circulation in exfoliation syndrome and exfoliation glaucoma. Graefes Arch Clin Exp Ophthalmol 2007 Apr;245(4):516-521.
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