Preoperative Ocular Hypotensives and Early Ocular Hypertension after Cataract Surgery

Kang, Jai Hoon; Ahn, Byung Heon

Abstract

Immediate postoperative changes in intraocular pressure (IOP) were prospectively studied in 60 patients after extracapsular cataract extraction and posterior chamber lens implantations, according to three different preoperative managements for cecreasing IOPs. In group 1 (24 patients), no ocular pressure reducing agents were given but only ocular massage was performed preoperatively. In group 2 (17 patients), intravenous mannitol (1.52g/kg of body weight) and/or 60ml of 50% oral glycerine was administered 1 hour before surgery. In group 3 (19 patients), 500mg of acetazolamide was administered orally 90 minutes before operation in addition to the regimen of group 2. A significant lllcrease in mean IOP was found 6 hours after the operation in group 1 by 5.6mmHg and in group 2 by 8.8mmHg when compared witt baseline IOP (p<0.05). However, there was no significant IOP rise in group 3. Postoperative IOPs in excess of 21mmHg occurred in 10 patients (42% )of group 1, seven patients (41 %) of group 2 and six patients(30%) of group 3. An IOP greater than 30mmHg was found in two patients (8%) in group 1, two patients (12%) in group 2 and one patient (5%) in group 3. From this study, it was concluded that acetazolamide 500mg given 90 minutes before operation resulted in a reduction of immediate postoperative IOP rise.