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Abstract #16850 Published in IGR 9-1
Risk factors for a postoperative intraocular pressure spike after phacoemulsification
O'Brien PD; Ho SL; Fitzpatrick P; Power WCanadian Journal of Ophthalmology 2007; 42: 51-55
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) mmHg; 2-3 hours postoperatively, 23.1 (7.0) mmHg; and 24 hours postoperatively, 17.0 (6.0) mmHg. 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.
Classification:
9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
