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[The cause and management of acute high intraocular pressure in phacoemulsification]
1ZhongShan Ophthalmic Center, Sun Yat-sen University of Medical Sciences, Guangzhou 510060, China.
Objective:
To investigate the cause and management of acute high intraocular pressure and shallow anterior chamber in phacoemulsification.
Methods:
A retrospective study was done on 1,500 eyes performed phacoemulsification. Eleven of 1,500 eyes showed higher intraocular pressure and shallowing of the anterior chamber during phacoemulsification. But phacoemulsification was successfully achieved after giving hyperosmotic agents, increasing infusion pressure and reducing aspiration rate as well as flow rate.
Results:
Of 11 eyes, 10 eyes were treated by management of non vitrectomy. One of 11 eyes was unresponsive to medical management and require the use of pars plana vitrectomy. Phaco was performed in all patients. In 4 of 11 eyes, visual acuity postoperatively were 0.7 or better. Five of 11 eyes were 0.3 to 0.5. One eye was 0.05 and one was HM/30 cm.
Conclusion:
Aqueous misdirection, retrobulbar hemorrhage and intraoperative suprachoroidal hemorrhage are common causes of acute high intracular pressure in phaco. Most of patients could be performed phaco after medical treatment. If patients failed to improve after medical treatment, par plana vitrectomy is a useful method.
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