Paul D O'Brien1, Su Ling Ho, Patricia Fitzpatrick, William Power. 1. Eye Department, Royal Victoria Eye & Ear Hospital, and the Department of Public Health Medicine and Epidemiology, University College Dublin, Ireland. mrpaulobrien@mac.com
Abstract
BACKGROUND: The aim of our study was to examine several potential risk factors for intraocular pressure (IOP) spikes 2 to 3 hours after phacoemulsification. METHODS: 50 eyes of 50 consecutive patients undergoing uncomplicated phacoemulsification under topical anesthesia were included in this prospective study. The following variables were recorded: preoperative IOP, nuclear colour, cortical lens opacity, posterior subcapsular lens opacity, patient age; and presence or absence of preexisting glaucoma. RESULTS: The mean IOP at each time interval was as follows: preoperatively, 14.5 (SD 3.4) mm Hg; 2-3 hours postoperatively, 23.1 (7.0) mm Hg; and 24 hours postoperatively, 17.0 (6.0) mm Hg. The postoperative IOP was significantly higher than baseline at 2-3 hours (p<0.001) and at 24 hours (p=0.002). Overall there were 10 cases (20%) of IOP spikes 2-3 hours postoperatively. Higher mean baseline IOP was significantly associated with postoperative IOP spikes (p=0.013). Patient age, sex, operating surgeon, absolute phacoemulsification time, lens nuclear colour, cortical opacity, and posterior opacity were not significantly different between groups with or without an IOP spike (p>0.05). INTERPRETATION: Patients with high IOP at the preoperative assessment are more likely to have IOP spikes after surgery and should be scheduled at the start of the operating list. In a day-case setting with restricted opening hours, postoperative checks in those patients at risk of IOP spikes can then coincide with the time IOP reaches its peak.
BACKGROUND: The aim of our study was to examine several potential risk factors for intraocular pressure (IOP) spikes 2 to 3 hours after phacoemulsification. METHODS: 50 eyes of 50 consecutive patients undergoing uncomplicated phacoemulsification under topical anesthesia were included in this prospective study. The following variables were recorded: preoperative IOP, nuclear colour, cortical lens opacity, posterior subcapsular lens opacity, patient age; and presence or absence of preexisting glaucoma. RESULTS: The mean IOP at each time interval was as follows: preoperatively, 14.5 (SD 3.4) mm Hg; 2-3 hours postoperatively, 23.1 (7.0) mm Hg; and 24 hours postoperatively, 17.0 (6.0) mm Hg. The postoperative IOP was significantly higher than baseline at 2-3 hours (p<0.001) and at 24 hours (p=0.002). Overall there were 10 cases (20%) of IOP spikes 2-3 hours postoperatively. Higher mean baseline IOP was significantly associated with postoperative IOP spikes (p=0.013). Patient age, sex, operating surgeon, absolute phacoemulsification time, lens nuclear colour, cortical opacity, and posterior opacity were not significantly different between groups with or without an IOP spike (p>0.05). INTERPRETATION:Patients with high IOP at the preoperative assessment are more likely to have IOP spikes after surgery and should be scheduled at the start of the operating list. In a day-case setting with restricted opening hours, postoperative checks in those patients at risk of IOP spikes can then coincide with the time IOP reaches its peak.
Authors: Pritha Roy; Ralitsa T Loewen; Yalong Dang; Hardik A Parikh; Igor I Bussel; Nils A Loewen Journal: BMC Ophthalmol Date: 2017-03-21 Impact factor: 2.209