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J.M. Ramocki, S. Lim; Punctal Plug Placement Prior to Giving Dilating Eyedrops Prevents Blood Pressure Spikes in Patients Undergoing Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):208.
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Purpose: To determine if punctal plugs can block blood pressure spikes from dilating eyedrops (2 1/2% phenylephrine) for cataract surgery Methods: Prospective randomized group of 11 patients (median age 70)(50% incidence of hypertension) receiving punctal plugs prior to being given dilating eyedrops were compared to a control group of 100 patients (median age 75)(69% incidence of hypertension). Pre-dilation blood pressures were measured along witha preoperative blood pressure measurement 15 minutes to 60 minutes after dilating eyedrops were given. Blood pressure spikes were defined as 10 mmHg elevation by combined systolic or diastolic readings from the pre-dilation reading. Results: One of 11 patients receiving punctal plugs had a blood pressure spike (9.1% incidence). This patient had a history of hypertension. 38 of 100 patients in the control group (38% incidence) with 76% of responders having a history of hypertension, had a blood pressure spike. Incidence of spike was 27% among non-hypertensives, 39% among patients on 1 antihypertensive, 46% among patients on 2 antihypertensives, and 66% among patients on 3 antihypertensive medications. Conclusions: Punctal plugs appear effective in reducing the incidence of blood pressure spikes among patients receiving dilating eyedrops prior to undergoing cataract surgery, and should be considered for use among patients undergoing cataract surgery with a history of hypertension, cardiac disease, or aneurysms.
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