Intraocular Pressure Reduction after Phacoemulsification versus Manual Small-Incision Cataract Surgery

Abstract

Both phacoemulsification and MSICS led to significant and similar IOP reductions 6 months after surgery, and both surgeries produced similar changes in anterior chamber and angle parameters. Higher baseline IOP was associated with greater IOP reduction; IOP reduction also can be attributed partly to changes in angle and anterior chamber configuration, although these parameters were unable to predict significantly predict IOP drop at 6 months.

Intraocular pressure variation after conventional extracapsular cataract extraction, manual small incision cataract surgery and phacoemulsification in an indigenous black population

“…Mean IOP at 6 weeks and 3 months in all 3 study groups was found to be lower than pre-operative IOP. The relatively lower mean IOP at 3 months observed in this study was in keeping with results from previous studies [ 7 , 12 , 16 ], and this further corroborates the fact that cataract surgery plays a role in increasing aqueous outflow facility in patients with open angles, as well as widens and deepens the AC angle in eyes with narrow angles as reported by previous studies [ 18 , 19 ]. Some factors other than the type of cataract surgery performed, such as the degree of inflammation, steroid responsiveness among others, could influence IOP changes following cataract surgery.…”

“…The steady decline in IOP observed in all 3 groups from 1 st day to 1 st week post-operative period may have been due to resolution of inflammation following post-operative steroid use and clearance of remnant viscoelastic material from the AC. Like in previous studies, patients who had phacoemulsification in this study had a decline in IOP from 1 st week to 3 rd week post-operative period [ 11 , 16 ]. On the other hand, IOP was found to increase in both ECCE and MSICS groups contrary to findings in other studies [ 7 , 16 ].…”

“…Like in previous studies, patients who had phacoemulsification in this study had a decline in IOP from 1 st week to 3 rd week post-operative period [ 11 , 16 ]. On the other hand, IOP was found to increase in both ECCE and MSICS groups contrary to findings in other studies [ 7 , 16 ]. Mean IOP at 6 weeks and 3 months in all 3 study groups was found to be lower than pre-operative IOP.…”

“…Sengupta et al . [ 16 ], in a study comparing IOP changes after MSICS versus phacoemulsification also reported a similar increase in IOP at 1st day post-operative period in the MSICS group. However, contrary to this finding, a slight but insignificant decrease in IOP was observed in the phacoemulsification group in this index study.…”

“…Smaller wound size as well as the activation of IL-1a and Endothelial leukocyte-adhesion molecule (ELAM)-1 expression may have been responsible for the decrease in IOP in the 1st day post-operative period. Some studies have reported a rise in IOP at the 1 st day post-operative period in patients who had phacoemulsification [ 10 , 11 , 16 ]. Differences in sample size and pre-operative IOP may have accounted for the disparity in the observed results.…”