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Abstract #8022 Published in IGR 4-3
Role of intraocular pressure measurement on the day of phacoemulsification cataract surgery
Browning AC; Alwitry A; Hamilton R; Rotchford A; Bhan A; Amoaku WMJournal of Cataract and Refractive Surgery 2002; 28: 1601-1606
PURPOSE: To determine whether measurement of intraocular pressure (IOP) preoperatively or in the early postoperative period is an accurate predictor of raised IOP 24 hours after cataract surgery. METHODS: This prospective study comprised 101 eyes of 101 patients having phacoemulsification cataract surgery. The IOP was measured by Goldmann applanation tonometry preoperatively and two to three, six to eight, and 22-24 hours postoperatively. The relationship between the same-day and next-day IOP readings was examined. RESULTS: One hundred patients completed the study. IOP at 22-24 hours was significantly correlated with the IOP preoperatively (correlation coefficient (r) 0.54; 95% confidence interval (CI), 0.38-0.67) and at six to eight hours (r = 0.56; 95% CI, 0.41-0.68). In contrast, the IOP measurement at two to three hours correlated relatively poorly with the next-day IOP (r) = 0.33; 95% CI, 0.14-0.49). Twelve patients had an IOP of 26 mmHg or higher at 22-24 hours. The risk of this outcome increased significantly with higher IOP values preoperatively and, to a lesser extent, with a raised IOP at six to eight hours. Glaucoma and ocular hypertension were associated with a 2.9-fold increased risk (95% CI, 0.67-12.8) of a next-day IOP of 26 mmHg or higher. CONCLUSIONS: Preoperative IOP or a diagnosis of glaucoma or ocular hypertension were significant risk factors for raised next-day IOP after small-incision phacoemulsification. It may be possible to select patients at greater risk of prolonged ocular hypertension before surgery for prophylactic IOP-lowering treatment. This would minimize patient morbidity and reduce the number of patients requiring next-day review, resulting in significant health economic savings.
A.C. Browning, MD, Department of Ophthalmology and Visual Sciences, Eye, Ear, Nose and Throat Centre, Queens Medical Centre, Nottingham, UK
Classification:
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
