Abstract
Purpose::
To compare frequency and severity of postoperative intraocular pressure (IOP) spikes after phacoemulsification with different ophthalmic viscosurgical device (OVD) at two institutions.
Methods::
Retrospective review of consecutive phacoemulsification cases from the Rocky Mountain Lions Eye Institute (RMLEI, Aurora, CO) and Denver Health Medical Center (DHMC, Denver, CO) between July 2005 and June 2006. Elevated post-operative intraocular pressure was defined as ≥ 25 mm Hg measured by Goldman applanation or tonopen.
Results::
A total of 1082 phacoemulsification cases were performed at both institutions (747 RMLEI and 335 DHMC). There were a total of 113 cases of elevated IOP on POD1, incidence 10.44% (84 cases, 11.11% incidence at RMLEI; 30 cases, 8.96% incidence at DHMC). The standard OVD used at RMLEI was Duovisc. The standard OVDs used at DHMC included Healon and Healon GV. Twelve cases (10.53%) of post-operative IOP elevation were associated with posterior capsule tears (7 at RMLEI and 5 at DHMC). One patient had a suprachoroidal hemorrhage, 4 patients had retained lens fragments, and 2 required a pars plana vitrectomy.
Conclusions::
Elevated post-operative IOP is a frequent complication of cataract surgery. Previous studies have shown variable responses to OVDs depending on the viscosity, molecular weight and retention of viscoelastic. Our data demonstrates a difference between the incidences of elevated post-operative IOP between two institutions. One possible explanation may be related to the different OVD used during cataract surgery.
Keywords: cataract • training/teaching cataract surgery • intraocular pressure