advertisement
Abstract #20087 Published in IGR 9-4
Evaluation of intraocular pressure in the immediate postoperative period after phacoemulsification
Shingleton BJ; Rosenberg RB; Teixeira R; O'Donoghue MWJournal of Cataract and Refractive Surgery 2007; 33: 1953-1957
PURPOSE: To determine the incidence of hypotony and intraocular pressure (IOP) elevation in the immediate and early postoperative period after temporal posterior limbal phacoemulsification and intraocular lens (IOL) implantation. SETTING: Ambulatory surgical center. METHODS: This prospective analysis comprised 310 eyes that had temporal posterior limbal phacoemulsification with IOL implantation. Surgical parameters included keratome incision of 2.85 mm, incision length of 2.5 mm, peribulbar anesthesia, case-completion IOP of 20 mmHg, and postoperative lid taping. The IOP measurements were collected preoperatively and 30 minutes and one day after surgery. RESULTS: Nineteen eyes (6.1%) had an IOP lower than 5 mmHg 30 minutes postoperatively in the absence of incision leakage at the paracentesis or keratome sites. Eighteen of the 19 eyes with postoperative hypotony received hydroxypropyl methylcellulose 2% (OcuCoat), and one received hypromellose 2% (Cellugel). None of the 23 eyes with an acrylic IOL implanted via a cylindrical lens inserter had an IOP lower than 5 mmHg postoperatively. Suturing did not significantly affect the incidence of hypotony, and there were no postoperative complications related to hypotony. The mean IOP at 30 minutes was lower than at one day in the normal, glaucoma, and glaucoma-suspect groups. Twenty-one normal eyes (8.1%), five glaucoma eyes (15.6%), and one glaucoma-suspect eye (5%) had an IOP greater than 30 mmHg one day postoperatively. CONCLUSIONS: Postoperative hypotony (IOP < 5 mmHg) occurred in 19 (6.1%) of 310 eyes. At one day, IOP higher than 30 mmHg was more frequent in glaucoma eyes than in normal eyes. Although there were no direct problems related to hypotony at 30 minutes or to elevated IOP (> 30 mmHg) at one day, surgeons should be aware of and check for IOP variability (low and high) that can occur in normal, glaucoma, and glaucoma-suspect eyes within the first 24 hours after surgery.
Dr. B.J. Shingleton, Ophthalmic Consultants of Boston, 50 Staniford Street, Suite 600, Boston, MA 02114, USA. bjshingleton@eyeboston.com
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)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
