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Anjum Cheema, Tehilla Stepansky, David Gritz, Anurag Shrivastava, Jeffrey Schultz; The Incidence of Early Postoperative IOP Spikes with Use of Healon 5 Viscoelastic® in Cataract Extraction with Phacoemulsification. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4721. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the incidence of early postoperative intraocular pressure (IOP) elevation after routine temporal clear corneal phacoemulsification and posterior chamber intraocular lens implantation in patients with and without a previous diagnosis of primary or secondary open angle glaucoma.
A retrospective analysis of 371 eyes (245 patients) undergoing cataract surgery at Montefiore Medical Center in Bronx, NY by the same surgeon (JS) from 2001-2010 was performed. The patients were divided into two groups: a cohort with (Group 1) and without (Group 2) glaucoma. Group 1 (n=135 eyes) included those diagnosed with primary or secondary glaucoma, glaucoma suspects secondary to optic nerve cupping, and ocular hypertension. Group 2 (n=236 eyes) included patients previously diagnosed with cataracts only. Average IOP on up to 5 preoperative visits was calculated and compared to postoperative day 1 IOP in both groups. All IOP medications were stopped in the immediate perioperative period for patients in Group 1 taking glaucoma drops. IOP elevation on the first postoperative day compared to the average preoperative IOP was stratified into the following groups: 5-10 mm Hg; 10-20 mm Hg; and >20 mm Hg.
Overall incidence of postoperative IOP elevations between 5-10mm Hg was 5.9%, representing an incidence of 4.4% in Group 1 and 6.8% in Group 2. The overall incidence of elevations of 10-20 mm Hg was 2.2%, representing an incidence of 2.2% in Group 1 and 2.1% in Group 2. The overall incidence of elevations >20 mm Hg was 0.5%, representing an incidence of 0.7% in Group 1 and 0.4% in Group 2. There was no statistically significant difference in change in IOP between Group 1 and Group 2 (p=0.58).
In this series, Healon 5 Viscoelastic® is associated with a relatively low incidence of early postoperative IOP spikes in populations both with and without glaucoma, and can be safely used in patients with glaucoma. Careful intraoperative removal of all viscoelastics is essential to reduce the likelihood of IOP-related complications.
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