A comparative study of postoperative intraocular pressure changes in small incision vs conventional extracapsular...

To compare short- and long-term IOP changes in small incision cataract surgery (SICS) vs conventional extracapsular cataract surgery (CECS).

A total of 232 eyes of as many patients undergoing cataract surgery were randomized to SICS or CECS. Sixteen eyes had to be excluded out of the study. IOP was recorded preoperatively and postoperatively on day 1, 2, and 7; and then after 1, 3, and 6 months. Only 160 eyes remained under 6-month follow-up, out of which 48 had CECS and remaining 112, SICS. Results were analysed statistically (repeated measure ANOVA, multiple comparisons).

A significantly higher IOP was observed on day 1, 2, and 7 in both types of surgeries as compared to mean preoperative IOP. Variation in rise was more pronounced in CECS (nearly twofold) than in SICS (P<0.05). Maximum decrease in IOP occurred during the first week and it was more rapid in SICS than CECS. At 3 months, IOP was significantly higher than baseline in CECS but significantly lower in SICS. From 3 to 6 months, there was no further decrease in IOP in either type of surgery.

IOP rises significantly on day one in CECS and SICS and thereafter comes down slightly by day 2 and rapidly by day 7. IOP rise is more pronounced in CECS than in SICS. After 1 week to 3 months, IOP decline is very gradual and thereafter ceases to decrease.