Abstract
Purpose :
Elevated intraocular pressure (IOP) following cataract surgery is the most frequent complication reported post-operatively and can lead to irreversible optic nerve damage and subsequent vision loss if left untreated. The effect of pre-operative IOP on the risk for having an elevated IOP 1 day post-operatively is uncertain for those without preexisting glaucoma or ocular hypertension (OHT). This study aimed to assess whether or not pre-operative IOP elevations were associated with IOP elevations on postoperative day 1 (POD1) in non-glaucomatous, non-OHT patients who have undergone uncomplicated phacoemulsification with intraocular lens (IOL) implantation.
Methods :
This is a retrospective analysis of IOL implantation surgical data between 1/1/2016-6/1/2018. Patients more than 60 years old with no history of glaucoma, OHT, pseudoexfoliation syndrome, pigment dispersion syndrome, eye trauma, use of IOP-lowering drops, or intraoperative complications were included. IOP was checked pre- and post-operatively within 16-30 hours of surgery using Goldmann applanation tonometer. The post-operative IOP was analyzed using analysis of covariance. P-value <0.05 was considered statistically significant. The WesternU Institutional Review Board approved this study.
Results :
A total of 288 patients were included in the analysis, with more than half of the patients (56.9%, n=164) being females and the average age being 73.4 (SD=6.72) years. The average pre-operative IOP was 15.98 (SD=2.83), and the average post-operative IOP was 19.47 (SD=5.87) mmHg. There was a significant change between the pre- and post-operative IOP (delta= 3.49, SD=5.28, p<0.001). Significant predictors for the post-operative IOP include pre-operative IOP (p<0.0001) and gender (p=0.012).
Conclusions :
Our results were consistent with the hypothesis that elevated pre-operative IOP was associated with POD1 IOP elevations in non-glaucomatous, non-OHT patients with uncomplicated phacoemulsification with IOL implantation. This knowledge may help clinicians identify individuals at significantly increased risk for IOP-related complications. Accordingly, this provides meaningful evidence in support of prophylactic pre-operative treatment in these high-risk patients in order to prevent vision loss due to post-operative elevations in IOP.
This is a 2020 ARVO Annual Meeting abstract.