Does Bariatric Surgery Affect Intraocular Pressure?
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ORIGINAL CONTRIBUTIONS
Does Bariatric Surgery Affect Intraocular Pressure? Mordechai Shimonov 1,2 Zvia Burgansky-Eliash 2,4
&
Idan Hecht 2,3 & Veronika Yehezkeli 2,4 & Idit Maharshak 2,5 & Asaf Achiron 2,5 &
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose The effect of body mass index (BMI) reduction following bariatric surgery on intraocular pressure (IOP) is not well established. We evaluated association between BMI reduction and IOP measurements and other ocular and metabolic parameters 1 year after bariatric surgery. Materials and Methods A retrospective study with over 1-year follow-up on patients who underwent weight reduction bariatric surgery between January 2016 and December 2016 at Wolfson Medical Center, Israel. Patient data was extracted from outpatient’s bariatric and ocular clinic records. Metabolic, ocular, and clinical parameters were assessed including BMI changes, IOP, central corneal and retinal nerve fiber layer thickness, optical coherence tomography, and biometry results. Results Of 22 bariatric surgery patients, 15 underwent laparoscopic sleeve gastrectomy (LSG) and 7 laparoscopic mini gastric bypass (MGB). All were followed up for over 1 year after surgery. Average BMI decreased from 41.9 ± 7.3 to 25.5 ± 5.7 kg/m2 at 1-year follow-up (p < 0.001). Mean IOP decreased significantly by 21% after 1 year (p < 0.001). Decrease in IOP 1 year after surgery was correlated with decrease in IOP at 3-month follow-up (r = 0.677, p = 0.001), preoperative IOP (r = 0.837, p < 0.001), and corneal thickness (r = 0.589, p = 0.006), with no correlation between reduction in IOP and baseline weight, BMI, or the reduction in either (p > 0.05). Central corneal thickness and retinal nerve fiber layer thickness were also significantly decreased (p = 0.038) and (p = 0.018), respectively. Conclusion BMI reduction achieved by bariatric surgery was associated with significant and continued decline in IOP beyond 1 year after surgery. Clinical implications highlight the importance of considering bariatric surgery in patients with ocular hypertension. Keywords Body mass index . BMI . Bariatric surgery . Intraocular pressure . IOP . Glaucoma
Introduction Obesity has been found to affect ophthalmic pathologies, such as age-related macular degeneration and diabetic retinopathy [1]. Several population-based studies have found an * Mordechai Shimonov [email protected] 1
Department of Surgery A, Edith Wolfson Medical Center, 62 Halochamim Street, Holon, Israel
2
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
3
Department of Ophthalmology, Shamir Medical Center, Zrifin, Israel
4
Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel
5
Department of Ophthalmology, Edith Wolfson Medical Center, Holon, Israel
association between obesity and high intraocular pressure (IOP), demonstrating individuals with obesity had higher IOP compared with normal-weight controls [2]. Such increases in IOP may affect the optic nerve and results in progression of gl
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