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David Lazar, Aryn C. Karpinski, Jayne S Weiss, Aravinda Rao; The Effect of Ocular Massage on Intraocular Pressure in Phakic eyes versus Pseudophakic eyes after Intravitreal Injections.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2664.
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© ARVO (1962-2015); The Authors (2016-present)
To determine differences in Intraocular pressure (IOP) after intravitreal injection (IVT) in phakic versus pseudophakic eyes with and without ocular massage.
A retrospective review of all eyes receiving bevacizumab agent given intravitreally by the same surgeon in a 3 month time period. Demographics including age, sex, lens status, ocular history, medications, and performance of ocular massage were recorded. Ocular massage consisted of 10 seconds of pressure on the globe with a cotton swab applicator soaked in 2% lidocaine. Exclusion criteria were a history of glaucoma, use of IOP lowering agents, and any patient with IOP of 26 or higher, and topical or intravitreal steroids for at least for 3 months. A calibrated tonopen was used prior to injection, immediately after injection and at 5, 10 and 15 minutes post-injection.
Sixty five eyes received IVT with 18 phakic eyes and 47 pseudophakic eyes. There was mean age of 72 (SD 11.22) in the phakic group and 82 (SD 5.85) in pseudophakic group which was statistically significant (P=.002) with a Welch T test which accounted for uneven sample size. The mean pre-injection IOP for the phakic group was 16.78 (SD 3.70) and pseudophakic group was 14.98 (SD 3.62) with no statistically significant difference (p=.079). The two groups were then subdivided into 4 groups: Phakic-Massage (P-M) N=12, Phakic-No Massage (P-NM) N= 6, Pseudophakic-Massage (PSK-M) N=28 and Pseudophakic-NO Massage (PSK-NM) N= 19. The mean IOPs at five minutes post-injection were P-M = 26.08 (SD7.5), P-NM = 34.33(SD6.4), PSK-NM = 28.16(SD5.2), PSK-M = 27.21(SD5.2). A split plot ANCOVA test was employed showed stastistically significant differences within the groups where the age-adjusted post-IOP means were significantly higher in the P-NM group (M=41.43, SE=2.74) compared to the P-M (M=32.60, SE=2.06; p=.009).
Phakic patients benefited the most from ocular massage in decreasing the post injection IOP spike. An age matched cohort study is necessary to investigate the age and lens status interaction to post IVT IOP spike.
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