Effect of high pressurization versus normal pressurization on changes in intraocular pressure immediately after clear corneal cataract surgery

PurposeTo compare changes in intraocular pressure (IOP) immediately after clear corneal incision (CCI) cataract surgery between eyes in which IOP was adjusted to a high or normal range at the conclusion of surgery.SettingHayashi Eye Hospital, Fukuoka, Japan.DesignComparative case series.MethodsEither eye of patients scheduled for phacoemulsification was randomized to 1 of 2 groups as follows: eyes that were to be adjusted to (1) high IOP (22 to 40 mm Hg) or (2) normal IOP (10 to 21 mm Hg). The IOP was measured using a rebound tonometer preoperatively; at the conclusion of surgery; and 15, 30, 60, 120, and 180 minutes and 24 hours postoperatively. The Seidel test and anterior segment optical coherence tomography (AS-OCT) were performed.ResultsThe mean IOP at the conclusion of surgery was 31.3 mm Hg in the high IOP group and 17.1 mm Hg in the normal IOP group. The IOP decreased to approximately 15 mm Hg by 15 minutes and did not change until 60 minutes in either group. The mean IOP did not differ significantly between groups throughout the observation period (P≥.0634). Hypotony of 5 mm Hg or less was not detected in any eye. The Seidel test was negative and based on AS-OCT, the wound was closed at 60 minutes in all eyes.ConclusionsAfter adjusting IOP to a high or normal range, the IOP normalized within 15 minutes postoperatively and was stable for 24 hours. The wound was closed within 60 minutes postoperatively.Financial DisclosureThe Hayashi Eye Hospital (Drs. Hayashi, Yoshida, Manabe, and Yoshimura) received a research grant for clinical trials of materials outside the submitted work sponsored by Alcon Japan Ltd., Santen Pharmaceutical Inc., Senjyu Pharmaceutical Ltd., Hoya Corp., Pfizer Japan, Inc., Novartis Pharma K.K., Wakamoto Pharmaceutical Ltd., Nitten Pharmaceutical Ltd., Japan Association of Health Service, and EBMs Ltd. Dr. Hayashi received lecture fees with or without travel expenses for materials outside the submitted work from Santen Pharmaceutical, Inc., Alcon Japan Ltd., and Pfizer Japan, Inc. No author has a financial or proprietary interest in any material or method mentioned.