Intraocular pressure after phacoemulsification using hydroxypropyl methylcellulose and sodium hyaluronate as viscoelastics

Phacoemulsification and intraocular lens [IOL] implantation has resulted in early visual rehabilitation, increased wound stability and improved refractive results. Viscoelastic substances [VES] are important adjuncts in this type of surgery. Use of VES in phacoemulsification can be associated with adverse effects, the most common and potentially dangerous of which is the transient rise in intraocular pressure [IOP] in post-operative period. To evaluate the effects of viscoelastic substances on post-operative IOP after phacoemulsification with implantation of intraocular lens, a cross-sectional comparative, prospective study was conducted in the department of Ophthalmology, Combined Military Hospital, Peshawar, Pakistan, from October 2003 to March 2004. one hundred patients were randomized into two groups of 50 each. Phacoemulsification with implantation of intraocular lens was performed in all patients. 2% Hydroxypropyl Methylcelloulose [HPMC] was used in one group and 1% Sodium Hyaluronate [NaHa] was used in the other group. IOP was measured pre-operatively as well as 24 hours and 7 days post-operatively. There was no significant difference in the pre-operative intraocular pressure between the two groups [p=0.483]. Twenty four hours after surgery, the mean IOP increased by 2.84 +/- SD 2.12 mm Hg in 2% Hydroxypropyl Methylcellulose group and 4.54 +/- 2.07 mm Hg in 1% Sodium Hyaluronate group. The increase returned to near pre-operative levels in both the groups. Sodium Hyaluronate causes significantly higher increase in intraocular pressure in early post-operative period after cataract surgery in spite of maximum aspiration of viscoelastic substance from the eye following phacoemulsification surgery

Cataract surgery; intraocular pressure in non-glaucomatous eyes with pseudo exfoliation syn drome

To investigate the course of intraocular pressure after cataract surgery in patients having pseudo exfoliation syndrome but without any evidence of glaucoma. Prospective age-matched comparative type. Department of Ophthalmology, Combined Military Hospital, Peshawar and Military Hospital, Rawalpindi. From 1st November 2003 to 30th April 2004. Ninety five patients having cataract, were divided into two groups. Group I consisted of forty five patients with pseudo exfoliation syndrome and Group II comprised control group of fifty patients not having pseudo exfoliation. All the patients underwent extra-capsular cataract extraction with posterior chamber intraocular lens implantation. The intra- ocular pressure was measured pre-operatively as well as on 7th post-operative day, 1st and 3rd post-operative months, in addition to other pre- and post-operative evaluation. Statistically, there was no significant difference in the pre-opera tive intraocular pressure between the two study groups. At 7th post-operative day, the intraocular pressure was below 18 mm of Hg in all the patients. First and 3rd month after the surgery, a decrease in intraocular pressure was observed. The inter-group differences in intraocular pressures at 1st and 3rd post-operative months were statistically not significant. Seven days after extra-capsular cataract extraction with posterior chamber intraocular lens implantation, no increase in intraocular pressure was observed in the eyes with pseudo exfoliation syndrome. Three months after cataract surgery, intraocular pressure levels decreased in eyes with pseudo exfoliation syndrome similarly as in control group