title: Increased intraocular pressure on the first postoperative day following resident-performed cataract surgery.
abstract: OBJECTIVE
  The aim of this study was to investigate the incidence of intraocular pressure (IOP) elevation after resident-performed cataract surgery and to determine variables, which influence postoperative day 1 (POD1) IOP.
  
  
  METHODS
  In all, 1111 consecutive cataract surgeries performed only by training residents between 1 July 2001 and 30 June 2006 were included. Elevated IOP was defined as ≥23 mm Hg. Surgeries were classified according to the presence of POD1-IOP elevation. Fisher's exact test and Student t-test were used to compare both groups. Multivariate analyses using generalized estimating equations were performed to investigate predictor variables associated with POD1-IOP elevation.
  
  
  RESULTS
  The average preoperative IOP was 16.0±3.2 mm Hg and the average POD1-IOP was 19.3±7.1 mm Hg, reflecting a significant increase in IOP (P<0.001, paired t-test). The incidence of POD1-IOP elevation ≥23 mm Hg was 22.0% (244/1111). Presence of glaucoma and ocular hypertension, higher preoperative IOP, and longer axial length were frequently encountered variables in the POD1-IOP elevation group (all P<0.05). Using a multivariate analysis, presence of glaucoma (P=0.004, OR=2.38; 95% confidence interval (95% CI)=1.31-4.30), presence of ocular hypertension (P=0.003, OR=6.09; 95% CI=1.81-20.47), higher preoperative IOP (P<0.001, OR=3.73; 95% CI=1.92-7.25), and longer axial length (P=0.01, OR=1.15; 95% CI=1.03-1.29) were significant predictive factors for POD1-IOP elevation.
  
  
  CONCLUSIONS
  IOP elevation on the first postoperative day following resident-performed cataract surgery occurred frequently (22.0%). Increased early postoperative IOP was associated with presence of glaucoma and ocular hypertension, higher preoperative IOP, and longer axial length.
authors.affiliation: Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. jykim2311@amc.seoul.kr
authors.forename: J Y
authors.initials: JY
authors.lastname: Kim
authors.forename: M-W
authors.initials: MW
authors.lastname: Jo
authors.forename: S C
authors.initials: SC
authors.lastname: Brauner
authors.forename: Z
authors.initials: Z
authors.lastname: Ferrufino-Ponce
authors.forename: R
authors.initials: R
authors.lastname: Ali
authors.forename: S L
authors.initials: SL
authors.lastname: Cremers
authors.forename: B An
authors.initials: BA
authors.lastname: Henderson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects* / Q000193:education; D005260:Female; D006801:Humans; D015994:Incidence; D007396:Internship and Residency; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D015999:Multivariate Analysis; D009798:Ocular Hypertension / Q000150:complications; D012307:Risk Factors; D014065:Tonometry, Ocular