Effect of acetylcholine on intraocular pressure following small-incision cataract surgery

40 patients, who underwent phacoemulsification and implantation of a polyHema intraocular lens (IOGEL-1103) were assigned to two groups. After evacuation of Healon from the capsular bag behind the lens and the anterior chamber, either 0.5 ml of 1% acetylcholine chloride or 0.5 ml of balanced salt solution was injected into the anterior chamber. When compared with preoperative values, the mean intraocular pressure (IOP) 6 h postoperatively was unchanged in the acetylcholine group (0 +/- 8.5 mm Hg) but increased in the control group (+4.1 +/- 7.4 mm Hg). 18 h postoperatively, the mean intraocular pressure slightly decreased in the acetylcholine group (-0.5 +/- 6.1 mm Hg) compared with an increase of +1.4 +/- 4.4 mm Hg in the control group. Intraocular pressure exceeding 25 mm Hg was observed at 6 h in 2 (10%) patients of the acetylcholine group and in 4 (20%) of the control group. At 18 h, intraocular pressure was elevated in only 1 (5%) patient of the acetylcholine group and in 3 (15%) of the control group. From these results, we conclude that the evacuation of Healon from the capsular bag behind the implanted lens and acetylcholine reduce the incidence of postoperative elevations of intraocular pressure.