Abstract
Purpose :
Cataract surgery stands as the most prevalent surgical procedure worldwide. Previous research has identified specific factors that contribute to intraocular pressure (IOP) elevation during the initial post-cataract surgery period. This includes male gender, high myopia, longer axial length, shallow anterior chamber depth, history of glaucoma treatment, use of alpha-adrenergic agonists for benign prostate hyperplasia, and elevated baseline IOP. However, the connection between an IOP spike in the first eye and its potential role as a risk factor for IOP spike in the second eye has not been explored. Our study's primary objective was to investigate this association while accounting for other predictors of an IOP spike following cataract surgery.
Methods :
This is a retrospective cohort study using the University of Colorado Cataract Outcomes Database. We studied patients who underwent cataract extraction via phacoemulsification for both eyes between January 1, 2014, and December 31, 2020. IOP spike was defined as a post-surgery day 1 IOP >30 mm Hg or IOP >10 mm Hg change from baseline. Patients who had an IOP spike in their second eye were compared to patients who did not. Multivariable logistic regression was used to assess our primary association with adjustment for potential confounding variables.
Results :
There were 5,226 patients who had cataract surgery in both eyes during the study period and had follow-up day 1 IOP measured in the clinic. The overall incidence of IOP spikes in the second eye was 4.6%, similar to the rate observed in the first eye at 4.5%. For patients who had an IOP spike in the first eye, the incidence of IOP spike in the second eye was 23.9%, whereas the rate was 3.8% for patients who did not have an IOP spike in their first eye (Chi-square test p<0.0001). Multivariate analysis of the predictors of IOP spike in the second eye resulted in an odds ratio of 7.91 (95%CI: 5.56, 11.3, p <0.0001) demonstrating that an IOP spike in the first eye is a significant predictive risk factor for an IOP spike in the second eye.
Conclusions :
Our results reveal the profound influence of an IOP spike in the first eye as a risk factor for an IOP spike in the second eye following cataract surgery even after accounting for other established preoperative and intraoperative risk factors. This finding highlights the necessity of recognizing and addressing this risk in patient care.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.