Purpose:
To examine the risk factors for postoperative intraocular pressure (IOP) spike in patients with primary open angle glaucoma (POAG) undergoing primary cataract extraction.
Methods:
Eighty consecutive patients with a diagnosis of POAG who underwent primary cataract extraction were identified. Patients who had an 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 undergo an IOP spike.
Results:
Seventeen patients (21%) underwent an IOP spike of greater than 10 mm Hg from their baseline IOP on postoperative day one. Statistically significant variables were age, preoperative gonioscopy angle grade, myopia, and refusal/forgot to take IOP prophylaxis medications.
Conclusions:
Aggressive prophylactic IOP lowering therapy should be considered in POAG patients undergoing cataract surgery. Factors that place patients at risk for a postoperative IOP spike include myopia, younger age and a refusal to use prophylactic IOP lowering medications.
Keywords: intraocular pressure • cataract