Early transient intraocular pressure spike after cataract surgery in highly myopic cataract eyes and associated risk factors

Br J Ophthalmol. 2020 Aug;104(8):1137-1141. doi: 10.1136/bjophthalmol-2019-315117. Epub 2019 Nov 8.

Abstract

Purpose: To investigate the incidence of the early transient intraocular pressure (IOP) spike after cataract surgery in eyes with highly myopic cataract (HMC) and associated risk factors.

Methods: Consecutive patients treated with phacoemulsification were recruited. IOP was measured before and 1 day, 3 days, 1 week and 3 months after surgery. Axial length (AL) and anterior chamber depth (ACD) were recorded, and optic disc tilt, rotation and beta-zone peripapillary atrophy (β-PPA) were measured from fundus photographs taken 1 week after surgery. Backward stepwise multiple linear regression was used to investigate the risk factors for early transient IOP spike in the HMC group.

Results: Finally, 94 eyes of 94 HMC patients and 67 eyes of 67 age-related cataract (ARC) controls were included in analysis. The incidence of early IOP spike was 10% in the ARC group and 28% in the HMC group (OR=3.277, p<0.05) at 1 day after surgery. In the HMC group with IOP spikes, more males were seen and affected eyes showed longer AL, shallower ACD, greater optic disc tilt, and larger β-PPA than those without (all p<0.05). Multivariate analysis showed that sex, AL, ACD, and area of β-PPA were significantly associated with an early transient IOP spike in HMC eyes (all p<0.05).

Conclusions: Highly myopic eyes are more susceptible to early transient IOP spike after cataract surgery, and male sex, longer AL, shallower ACD, and greater β-PPA are associated risk factors.

Clinical trial registration number: NCT02182921.

Keywords: intraocular pressure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anterior Chamber / pathology
  • Axial Length, Eye / pathology
  • Cataract / complications*
  • Female
  • Humans
  • Incidence
  • Intraocular Pressure / physiology*
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications*
  • Ocular Hypertension / epidemiology*
  • Ocular Hypertension / physiopathology
  • Phacoemulsification*
  • Postoperative Complications
  • Risk Factors
  • Tomography, Optical Coherence
  • Tonometry, Ocular

Associated data

  • ClinicalTrials.gov/NCT02182921