Evaluation of intraocular pressure in the immediate postoperative period after phacoemulsification.
OBJECTIVE
To determine the incidence of hypotony and intraocular pressure (IOP) elevation in the immediate and early postoperative period after temporal posterior limbal phacoemulsification and intraocular lens (IOL) implantation.


METHODS
Ambulatory surgical center.


METHODS
This prospective analysis comprised 310 eyes that had temporal posterior limbal phacoemulsification with IOL implantation. Surgical parameters included keratome incision of 2.85 mm, incision length of 2.5 mm, peribulbar anesthesia, case-completion IOP of 20 mm Hg, and postoperative lid taping. The IOP measurements were collected preoperatively and 30 minutes and 1 day after surgery.


RESULTS
Nineteen eyes (6.1%) had an IOP lower than 5 mm Hg 30 minutes postoperatively in the absence of incision leakage at the paracentesis or keratome sites. Eighteen of the 19 eyes with postoperative hypotony received hydroxypropyl methylcellulose 2% (OcuCoat) and 1 received hypromellose 2% (Cellugel). None of the 23 eyes with an acrylic IOL implanted via a cylindrical lens inserter had an IOP lower than 5 mm Hg postoperatively. Suturing did not significantly affect the incidence of hypotony, and there were no postoperative complications related to hypotony. The mean IOP at 30 minutes was lower than at 1 day in the normal, glaucoma, and glaucoma-suspect groups. Twenty-one normal eyes (8.1%), 5 glaucoma eyes (15.6%), and 1 glaucoma-suspect eye (5%) had an IOP greater than 30 mm Hg 1 day postoperatively.


CONCLUSIONS
Postoperative hypotony (IOP <5 mm Hg) occurred in 19 (6.1%) of 310 eyes. At 1 day, IOP higher than 30 mm Hg was more frequent in glaucoma eyes than in normal eyes. Although there were no direct problems related to hypotony at 30 minutes or to elevated IOP (>30 mm Hg) at 1 day, surgeons should be aware of and check for IOP variability (low and high) that can occur in normal, glaucoma, and glaucoma-suspect eyes within the first 24 hours after surgery.
Shingleton
Bradford J
BJ
Ophthalmic Consultants of Boston, 50 Staniford Street, Suite 600, Boston, Massachusetts 02114, USA. bjshingleton@eyeboston.com
Rosenberg
Rhonda B
RB
Teixeira
Roberta
R
O'Donoghue
Mark W
MW
D000368:Aged; D002386:Cataract / Q000150:complications; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000502:physiology*; D019654:Lens Implantation, Intraocular; D008297:Male; D009798:Ocular Hypertension / Q000150:complications; D018918:Phacoemulsification; D011184:Postoperative Period; D011446:Prospective Studies; D014065:Tonometry, Ocular