Intraocular Pressure Changes after Uneventful Phacoemulsification in Early Postoperative Period in Healthy Eyes

Abstract

The aim was to determine early changes in intraocular pressure (IOP) following uneventful phacoemulsification and intraocular lens (IOL) implantation in healthy eyes. This prospective interventional case series study was conducted at Ophthalmology Department, Kragujevac Clinical Centre, Kragujevac, Serbia. The study included 123 eyes of 123 cataract patients, 66 women and 57 men, age range 50-88 (mean 70.73±7.94) years having undergone phacoemulsification and in-thebag implantation of a foldable IOL. The patients were treated at Kragujevac Clinical Centre between June 2015 and May 2016. IOP was measured by Goldmann applanation tonometry preoperatively, then 4-6 hours, 18-24 hours and 7 days postoperatively by the same examiner. The mean IOP preoperatively was 15.10±2.68 mm Hg. In three patients, maximum measured IOP was 22 mm Hg. At 4-6 hours postoperatively, the mean IOP was 24.29±7.56 mm Hg (p<0.001), at 18-24 hours it was 18.37±4.80 mm Hg (p<0.001), and 7 days after the surgery the mean IOP was 16.24±2.90 mm Hg (p<0.05). The measured IOP values were statistically significant in all measured times. However, at 4-6 hours and 18-24 hours, the mean IOP value was highly statistically significant (p<0.001). Although 7 days after the surgery IOP normalized, the mean IOP value was statistically significant (p<0.05). In conclusion, our research showed that even eyes with normal preoperative values and uncomplicated phacoemulsification course can show very high IOP values postoperatively, which can cause pain, blurred vision and, rarely, compromise visual function.

Risk factors of intraocular hypertension after phacoemulsification and intraocular lens implantation in normal eyes

“…In other words, although high IOP may bring discomfort to patients after the surgery, such as intraocular swelling pain, corneal edema, and poor visual recovery in the early stage of cataract surgery, short-term high IOP rarely causes irreversible damage to the visual function of patients. 7 We foundno signi cant difference in terms of sex (P > 0.05). In terms of age, the mean age of patients in the high-IOP group (55.3 ± 12.2 years) was signi cantly lower than that in the normal-IOP group (67.7 ± 10.0 years) (S.Table 1).…”

“…The pathogenesis of IOP elevation is multifactorial; it involves in ammation, hemorrhage, pigment dispersion, and retained viscoelastic material, lens, or iris debris. 2 However, some patients may not have these problems.…”

Changes in Intraocular Pressure (IOP) after Phacoemulsification in Eyes with Occludable Angle Of Anterior Chamber

“…[5][6][7][8]12,17,18 Phacoemulsification aids in reducing the intraocular pressure and has distinct advantages. [19][20][21] Various studies have shown the role of thickened cataractous lens as a cause for increased IOP. Therefore, after phacoemulsification the human lens being a risk factor contributing to glaucoma is removed.…”

“…Therefore, after phacoemulsification the human lens being a risk factor contributing to glaucoma is removed. 19,20 The need for anti-glaucoma medications might be reduced or in certain cases eliminated. 22 Shingleton BJ et al compared IOP of OAG patients with controlled patients, glaucoma suspects and normal controls 3 and 5 years after phacoemulsification.…”

Phacoemulsification: Proposals for Improvement in Its Application

“…If left untreated, uncontrolled postoperative IOP spikes can lead to pain, corneal oedema, and glaucomatous optic nerve damage. The pattern of IOP change shows a gradual peak increase in the first postoperative hours at four and six hours followed by a normalisation of pressure a day later [77].…”