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A. Day, M. Kalev Landoy, C. Migdal; Raised Intraocular Pressure after Routine Phacoemulsification in Glaucoma Patients and Normals . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5485.
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To determine the prevalence of raised intraocular pressure (IOP) requiring treatment following uncomplicated phacoemulsification with lens implantation in normals, glaucoma suspects and patients with medically controlled glaucoma.
A prospective comparative observational study of 46 consecutive patients undergoing routine uncomplicated phacoemulsification with intraocular lens implantation. 33 patients had no evidence of glaucoma, 7 patients had glaucoma controlled on medications, 4 patients had controlled ocular hypertension (OHT), 1 patient was a glaucoma suspect and 1 patient had pseudoexfoliation without glaucoma. No patients had had previous intraocular surgery. A standard surgical protocol was applied to each patient. Baseline IOP was determined at the time of listing for surgery. IOP was measured 1–2 hours, 1 day, 2 weeks and 2–3 months following surgery. A raised IOP was defined as IOP >25mmHg.
Raised postoperative IOP was found in 7/33 (21%) of the non–glaucoma patients, 4/7 (57%) of the glaucoma patients, 3/4 (75%) of the OHT patients and in the patient with the pseudoexfoliation. The elevated IOP was noted on day 1 following surgery in the OHT patients, in 6 of the non–glaucoma patients and in the patient with the pseudoexfoliation. In the glaucoma patients the raised IOP was noted in both the immediate post–operative period and on day 1. All IOPs were normal 2 weeks following surgery.
Patients with glaucoma or OHT are at higher risk of developing raised IOP following phacoemulsification and implant surgery than non–glaucoma patients. Surgical protocols in these patients should include prophylactic hypotensive medical therapy if follow–up examinations are not possible in the immediate post–operative period.
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