Influence of Ocular and Systemic Variables on Intraocular Pressure Change Following Phacoemulsification in...

To evaluate the influence of preoperative ocular and systemic variables on intraocular pressure (IOP) change following phacoemulsification cataract extraction with intraocular lens (CEIOL) implantation in eyes without glaucoma.

This retrospective cohort study included adults who underwent standalone CEIOL at a single academic center between 2017 and 2020. Preoperative demographic, ocular, and systemic health data were extracted from electronic health records using an informatics-based approach and validated by chart review. Eyes with glaucoma or other preoperative ocular conditions known to affect IOP were excluded. Postoperative IOP data were collected for up to 2 years and censored at the time of any subsequent diagnosis or treatment likely to influence IOP. A linear mixed-effects model was used to assess associations between IOP change and preoperative ocular (e.g., IOP, axial length, central corneal thickness) and systemic variables (e.g., diabetes, body mass index [BMI], smoking status), accounting for inter-eye correlation.

A total of 1992 eyes from 1755 patients were included. Higher preoperative IOP ( $\beta$ = -0.563, P $<$ 0.001) and female gender ( $\beta$ = -0.229, P = 0.005) predicted greater postoperative IOP reduction. Longer axial length ( $\beta$ = 0.201, P $<$ 0.001), diabetes mellitus ( $\beta$ = 0.291, P = 0.019), thicker cornea ( $\beta$ = 0.008, P $<$ 0.001), and higher BMI ( $\beta$ = 0.022, P = 0.005) were associated with a relative increase in postoperative IOP.

Both ocular and systemic variables significantly influenced postoperative IOP change following CEIOL in non-glaucomatous eyes. Understanding these associations may improve clinical decision-making and help tailor IOP-related counseling for patients undergoing cataract surgery.