Incidence of Increased Intraocular Pressure on Postoperative Day 1 Following Cataract Surgery

Abstract

Abstract: : Purpose: To better understand the incidence of increased intraocular pressure (IOP) after cataract surgery and the variables that influence IOP on postoperative day one. Methods: A retrospective chart review of 338 eyes undergoing cataract extraction and intraocular lens implantation from January 1, 2004 to October 31, 2004 was performed. Data was analyzed with respect to preoperative and postoperative intraocular pressure, history of glaucoma or IOP lowering medication use, type of viscoelastic used during surgery, and the presence of intraoperative complications including posterior capsular tear, zonular dialysis, and need for vitrectomy. Increased intraocular pressure was defined as greater than or equal to 22 mmHg. Results: The average preoperative IOP was 16.7 mmHg and the average postoperative IOP was 19.6 mmHg (p≤0.0001). The incidence of increased intraocular pressure on the first postoperative day after cataract surgery was 27%. There was no significant relationship between glaucoma or IOP lowering medication use and increased IOP on postoperative day one following cataract surgery. Increased IOP was associated with the presence of posterior capsular tears (p≤0.025, RR=1.86) and any intraoperative complication (p≤0.01, RR=1.86). Viscoelastic use during surgery (hyaluronic acid alone or hyaluronic acid and chondroitin sulfate) (p=0.20) and zonular dialysis (p=0.4) did not have a significant effect on IOP on postoperative day one after cataract surgery. Conclusions: Increased IOP on postoperative day one following cataract surgery occurs frequently (27%) and has no relation to previous history of glaucoma. Increased pressure is associated with intraoperative complications and posterior capsular tears but is independent of the type of viscoelastic solution and zonular dialysis.

Keywords: cataract • intraocular pressure