Incidence of preoperative high blood pressure in cataract surgery among hypertensive and normotensive patients

Abstract

Incidence of preoperative rise in blood pressure (BP) in cataract surgery among hypertensive and normotensive patients.Objective:To study the incidence of preoperative rise in BP in cataract surgery among normotensive individuals and hypertensive patients with historic good BP control in a population without other major chronic diseases.Settings:Ophthalmology Service of a University Hospital.Materials and Methods:A prospective study with 822 patients older than 40 years of age, with cataract surgery indication, and without major chronic diseases other than hypertension. The patients were divided in two groups: hypertensive and normotensive. Preoperative data, physical exams and medical adverse events were recorded in an evaluation questionnaire.Results:The sample included 427 normotensive (52%) and 395 hypertensive patients (48%). The two groups had similar proportions of operations that were cancelled and not subsequently rescheduled, 2% (eight patients) in each group. The incidence of preoperative rise in BP was 3.7% in the normotensive group and 10.9% in the hypertensive group (P < 0.001).Conclusion:Hypertensive patients with historic good BP control and without other major co-morbidities present a larger incidence of preoperative rise in BP than normotensive individuals in cataract surgery.

Is perioperative blood pressure monitoring during intravitreal injections important?

“…[1][2][3] A perioperative rise in blood pressure (BP) has been noted during cataract surgery. [4][5][6][7][8] In fact, the guidelines from the American Academy of Ophthalmology suggest that BP monitoring should be performed during cataract surgery by personnel, other than the operating ophthalmologist, who is qualified to monitor and manage the patient's systemic status. 9,10 In addition to the intraoperative BP rise, intravitreal anti-VEGF injections have been demonstrated to increase the lifelong risk of cardiovascular and cerebrovascular events.…”

Effect of intracameral phenylephrine on systemic blood pressure

“…1 Hypertension is a comorbidity for half of patients undergoing cataract operations, and even if medically controlled these patients are already at risk of preoperative rises in blood pressure. 2 Similar studies investigating the blood pressure effects of intracameral adrenaline found no intraoperative fluctuations in blood pressure as compared to or as adjuncts to topical mydriatics. 3,4 The only existing literature regarding complications of I/C PE indicates that its use is not associated with any statistically significant changes in surgical outcomes, 5 although the study in question did not directly measure the circulatory effects.…”

“…It has already been documented that SSRIs increase the risk of gastrointestinal bleeding 1 and intracranial hemorrhage. 2 de Abajo 3 summarizes the mechanism by which the SSRIs potentiate bleeding. Platelets cannot synthesize serotonin; rather, serotonin is stored in platelets and released by certain stimuli to induce vasoconstriction and platelet activation, and to enhance fibrin formation.…”

Causes for Postponement of Cataract Surgery in a Peripheral Eye Hospital

“…Rodrigo et al found that the hypertensive patients with good BP control and without other major comorbidities present a larger incidence of preoperative rise in BP than normotensive individuals. 8 Good long term BP control should protect the patient from the risk of last minute cancellation because of high BP.…”