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[Factors influencing early post surgical ocular hypertension after phacoemulsification]
J Feys1, F Fajnkuchen, A Salvanet-Bouccara
1Service d'Ophtalmologie, Centre Hospitalier Intercommunal, 40, Allée de la source, 94195 Villeneuve-St-Georges Cedex.
Purpose:
To evaluate factors influencing early post surgical ocular hypertension after phacoemulsification.
Methods:
Records were collected for patients who had uncomplicated phacoemulsification with IOL implantation in the bag. Aspiration of the viscoelastic was performed at the conclusion of surgery. Patients with previous ocular surgery, high myopia, or glaucoma were excluded. Intraocular pressures were measured at six hours (+/-2) postoperatively. Following factors were analysed
Results:
26% of the patients had an ocular pressure equal or higher than 21 mmHg. Among the factors we analysed, pilocarpine injection was the only one to produce significant decrease in postoperative ocular pressure.
Comments:
The acute postoperative IOP increase following phacoemulsification is presumably the result of trabecular obstruction by viscoelastic material. However it can occur despite meticulous evacuation of viscoelastic, which could be dependent upon the material's viscosity, and IOL material and design. Postoperative ocular hypertension is not related to ultrasonic duration. Intracameral injection of pilocarpine significantly reduces the incidence of postoperative intraocular pressure increase.
Conclusion:
Early postoperative ocular hypertension can be observed with different kinds of viscoelastics and IOL. Meticulous evacuation of viscoelastic from anterior chamber, although necessary does not always prevent this early complication. Intracameral injection of pilocarpine can reduce its incidence.