Change in intraocular pressure within 1 week of phacoemulsification and intraocular lens implantation using Adatocel.
OBJECTIVE
To examine the change in intraocular pressure (IOP) within 1 week of phacoemulsification and foldable posterior chamber intraocular lens (PC IOL) implantation using Adatocel (hydroxypropyl methylcellulose 2% [HPMC]).


METHODS
Department of Ophthalmology, University of Sciences, Faculty of Medicine, Pécs, Hungary.


METHODS
In this prospective study, the IOP in 118 eyes of 118 patients (57 men, 61 women, mean age 68 years +/- 7.8 [SD]) with no history of glaucoma was assessed by Goldmann applanation tonometry 2 to 3, 6 to 8, and 22 to 24 hours and 1 week after uneventful phacoemulsification and PC IOL implantation. The effect of the removal of Adatocel ("partial removal" from the anterior chamber [AC] only versus "complete removal" from behind of the IOL as well), the lens type (Medicontur 601 HP versus Bausch & Lomb Hydroview), and the type of anesthesia (topical versus parabulbar) were compared. Statistical analysis was performed using the Student t test, and P< or =.05 was considered statistically significant.


RESULTS
The mean preoperative IOP was 13.83 +/- 2.5 mmHg. There were no significant differences at any time in postoperative IOP measurements between the 2 IOL types and the 2 modes of anesthesia. At 2 to 3 hours, 6 to 8 hours, and 22 to 24 hours, the IOP was significantly higher in the 30 eyes in which the Adatocel was partially removed (from the AC only) than in the 88 eyes in which it was completely removed (from behind the PC IOL as well) (P< or =.05, P< or =.01, and P< or =.001, respectively).


CONCLUSIONS
Severe postoperative IOP spikes in nonglaucomatous patients after uneventful phacoemulsification cataract surgery are rare. The type of implanted PC IOL and the mode of anesthesia had no significant effect on postoperative IOP. Total removal of the ophthalmic viscosurgical device, even when using HPMCs such as Adatocel, is necessary to prevent postoperative IOP spikes.
Biro
Zsolt
Z
Department of Ophthalmology, University of Pecs, Medical School Pécs, Hungary. zsolt.biro@aok.pte.hu
Balogh
Teodora
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods; D005260:Female; D006801:Humans; D065347:Hypromellose Derivatives; D007429:Intraocular Pressure / Q000187:drug effects*; D019654:Lens Implantation, Intraocular; D008297:Male; D008747:Methylcellulose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D009798:Ocular Hypertension / Q000139:chemically induced*; D009883:Ophthalmic Solutions / Q000009:adverse effects* / Q000627:therapeutic use; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D014065:Tonometry, Ocular
D009883:Ophthalmic Solutions; D065347:Hypromellose Derivatives; D008747:Methylcellulose