ABSTRACT
Introduction: Transient intraocular pressure rise is acommonly observed phenomenon following Nd:YAGcapsulotomy. However, IOP change is considered to bedependent on multiple factors. Study aimed to assess factorsdetermining the IOP change following Nd:YAG capsulotomy.Material and Methods:A total of 150 adult patients, scheduledto undergo Nd:YAG laser capsulotomy for management ofposterior chamber opacification (PCO) were enrolled. Age,gender, time since cataract surgery, PCO grade, IOP, topicalhypotensive use was noted in all the cases. Amount of energyused in Nd:YAG procedure was recorded. Postoperative IOPchange was noted immediately, 1 hr and 3 hr postoperativeintervals. Rise >5 mm was considered clinically significant.Independent samples ‘t’-test, Chi-square test and binarylogistic regression were used. Data analysis was performedusing SPSS 15.0 software.Results: Mean age of patients was 60±11.3 years. Majoritywere females (59.3%). Majority of patients had Grade I andII of PCO (64%), 5-10 years duration since cataract surgery(79.3%) and topical hypotensive use was done(58%).Preoperative mean IOP was 15.99±2.72 mmHg. Energyused was 55.7±52.7 mJ. A total of 19 (12.7%) patients hadIOP rise >5 mm. On univariate analysis, Grade III or abovePCO, higher level of total energy use and low hypotensive usewere found to be significantly associated with IOP rise. Onmultivariate assessment, low hypotensive use and high energyuse were found to be significantly associated with clinicallysignificant IOP rise (p<0.05).Conclusions: Low energy and prophylactic topicalhypotensives were protective against IOP rise.
ABSTRACT
Purpose: This study was designed to analyze the risk factors resulting in high intraocular pressure (IOP), which was accepted as IOP higher than 22 mmHg, following uncomplicated phacoemulsification. Materials and Methods: The records of 812 eyes of 584 patients who underwent uncomplicated phacoemulsification were evaluated. There were 330 men and 254 women ranging between the age of 26 and 89 years (65.4 ± 9.8 years). The preoperative, postoperative first day (day 1), first week (day 7), and first month (day 30) IOP values were analyzed. Data on history of diabetes, glaucoma, pseudoexfoliation (PXF), incision site, capsular staining with trypan blue, and surgeon were recorded. A multinomial regression analysis was performed to analyse the relationship of the factors with postoperative high IOP. Results: The mean IOP was 15.6 ± 4.3 mmHg preoperatively. Postoperatively that were changed to 19.7 ± 9.0 mmHg at day 1, 12.7 ± 4.5 mmHg at day 7, and 12.8 ± 3.7 mmHg at day 30. The factors such as surgeon, presence of PXF, diabetes, surgical incision site, and trypan blue were not related to the postoperative high IOP (P > 0.05, in all). The only factor that related to high IOP at all visits was glaucoma (P < 0.005). Conclusion: According to our results, preoperative diagnosis of glaucoma seems to be the only factor to affect the postoperative IOP higher than 22 mmHg.
ABSTRACT
Rebleeding in traumatic hyphema may cause several complications in the affected eye, and specific treatment of recurrent hyphema is still not estabilished and only conservative medical treatments are used except for surgical evacuation of the clot in case of persistent high intraocular pressure. We treated longstanding recurrent hyphema patient unresponsive to conventional medical treatment, with viscoeleastic substance which was injucted into anterior chamber. A large dose(0.2CC) of viscoelastic substance sufficient to directly compress the anterior structures(Iris, ciliary body) was injected and subsequently it increased the intraocular pressur gradually. We assume that these tamponade effect by the viscoelastic substance and later intraocular pressure rise was responsible for the therapeutic effect. Thus, viscoelastic injection into anterior chamber in longstanding recu.rrent hyphema patient may be a useful treatment.