Homeostatic response of intraocular pressure in the early period after sutureless phacoemulsification

To determine the homeostatic response of postoperative intraocular pressure (IOP) by analyzing postoperative IOP trends after sutureless phacoemulsification.

Asan Medical Center, Seoul, South Korea.

Comparative case series.

Normotensive eyes were treated with sutureless phacoemulsification with in-the-bag posterior chamber IOL (PC IOL) implantation. The patients were randomly divided into 3 groups according to the intended immediate postoperative IOP as follows: Group 1, IOP less than 10 mm Hg; Group 2, IOP 10 to 21 mm Hg; Group 3, IOP over 21 mm Hg. The surgeon intentionally attempted supranormal, normal, or subnormal pressurization. The IOP was measured immediately after surgery and 2 hours, 4 hours, 1 day, 1 week, and 1 month postoperatively.

Group 1 included 88 eyes (27.8%), Group 2 included 130 eyes (41.2%), and Group 3 included 98 eyes (31.0%). The mean IOP immediately after surgery was 6.4 mm Hg ± 2.0 (SD), 14.5 ± 3.2 mm Hg, and 27.0 ± 4.6 mm Hg, respectively, with significant differences between the 3 groups (P<.05). However, the IOP values were nearly normalized in the 3 groups 2 to 4 hours postoperatively. Twenty-eight eyes (8.9%) had an IOP lower than 5 mm Hg immediately after surgery in the absence of incision leakage. There were no postoperative complications related to hypotony. Thirty-one eyes (9.8%) had an IOP of at least 30 mm Hg immediately after surgery; the IOP normalized by 1 day postoperatively.

In normal eyes that had uneventful sutureless phacoemulsification with in-the-bag PC IOL implantation, immediate postoperative high or low IOP did not affect the return to baseline levels.