Effect of Cataract Surgery on Intraocular Pressure in Non-Glaucomatous Patients- A Prospective Study

Abstract

Soumyadeep Majumdar1 , Madhurima Chandra 2

BACKGROUND Variations in the IOP beyond the normal range can lead to different pathologies that are associated with difficulty in vision. Inside the closed space of the globe, cataractous changes along with never ending growth of crystalline lens have been theoretically thought to be associated with a rise in IOP. Distribution of different types of cataracts and the sequential change of IOP in different morphological types of cataract after phacoemulsification with foldable PCIOL implantation in the capsular bag is the sole aim of this study. METHODS This is a prospective observational study. Selected patients with no features of glaucoma, after meeting proper inclusion and exclusion criteria were included in the study. 426 eyes underwent phacoemulsification with PCIOL implantation (by a single competent surgeon using same phacoemulsification machine with similar parameters) were subjected to measurement of IOP by Goldmann Applanation Tonometry 3 days prior to surgery and postoperative day 14 and 28 respectively. Before surgery, dilated pupillary examination was performed to assess the grade of cataract. Data was collected and results analysed thereafter. RESULTS Among 426 eyes evaluated (M:F=1.8:1), with mean age of 54.49 (±6.975) yrs., commonest type of cataract found was Nuclear Sclerosis Grade III (19.9%) followed by Nuclear Sclerosis Grade II (16.4%). Mean preoperative IOP was 16.55 (±1.953) mmHg. Mean postoperative IOP on day 14 and day 28 was 15.11 (±1.755) mmHg and 15.04 (±1.800) mmHg respectively. Nuclear Sclerosis grade V had the least preoperative IOP among all the groups whereas mature cataracts with highest preoperative IOP showed highest fall of IOP after surgery. 8.2% patients who had traumatic cataract which did not show significant postoperative reduction of IOP. CONCLUSIONS Cataract surgery by phacoemulsification and PCIOL implantation reduces IOP in majority of non-glaucomatous patients. Non-diabetic, non-traumatic cataracts and mature cataracts show maximum postoperative reduction of IOP

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