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Daniel B. Moore, Mark A. Slabaugh, Karine Bojikian, Philip P. Chen; Risk Factors For Post Phacoemulsification Iop Spike In OAG Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5065.
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To examine the risk factors for postoperative intraocular pressure (IOP) spike in patients with open angle glaucoma (OAG) undergoing primary cataract extraction.
We surveyed 205 consecutive eyes with a diagnosis of OAG who underwent primary cataract extraction by a single surgeon. Patients who had a IOP spike of greater than 10 mmHg above their baseline pressure on postoperative day one were identified. Baseline characteristics were obtained and compared to patients who did not experience a IOP spike.
Thirty-four patients (16%) had a IOP spike of 10mmHg or greater. Patients with a IOP spike were more likely to be male (19/79 vs 15/126, P = 0.023), have a younger age (70.7 ± 11.0 vs 75.9 ± 9.8 years, P = 0.006), wider angles on preoperative gonioscopy (Shaffer grade 3.48 ± 0.6 vs 2.97 ± 0.8, P = .002), longer axial length (AL) (25.08 ± 2.4 vs 24.1 ± 1.7 mm, P = 0.004), deeper anterior chamber (AC) (3.28 ± 0.4 vs 3.02 vs 0.5 mm, P = 0.004), undergone laser trabeculoplasty (LTP) prior to surgery (14/40 vs 20/165, P = 0.001) or refused or forgot to take IOP prophylaxis medications (14/49 vs 19/154, P = 0.014).
Our study suggests prophylactic IOP lowering therapy should be used in OAG patients undergoing cataract surgery. Factors that may place patients at risk for a postoperative IOP spike include male gender, younger age, wider angles, longer AL, deeper AC, prior LTP and omission of prophylactic IOP lowering medications.
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