Phacoemulsification cataract surgery: is routine review necessary on the first post-operative day?

Tan, Jennifer; Newman, D K; Klunker, C; Watts, S E; Burton, Robert L.

doi:10.1038/eye.2000.11

Cited by 58 publications

(51 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…During the transition of cataract surgery from extracapsular cataract extraction to phacoemulsification, it was noted that the day-1 postoperative intervention rate after routine phacoemulsification was around 3% and this was deemed sufficiently low to justify the omission of the day-1 visit. [18][19][20] Allan et al 18 suggest that if the intervention rate is o5%, the visit is probably unnecessary, apart from the mutual reassurance for the patient and the surgeon.…”

Section: Discussionmentioning

confidence: 99%

“…20 However, the IOP spike after VR surgery can persistent for at least 2 weeks. 15 It remains unclear whether a raised IOP for a short period is damaging, in the absence of pre-existing glaucoma.…”

Section: Discussionmentioning

confidence: 99%

“…15 It remains unclear whether a raised IOP for a short period is damaging, in the absence of pre-existing glaucoma. 20 Gosse et al 21 conjecture that the sutureless transconjunctival incisions used for 23G vitrectomy can act as one-way valves, allowing the release of a small amount of air if the IOP increases significantly. IOP spikes following vitrectomy may become less common as the use of small-gauge vitrectomy instruments becomes more widespread.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Is day-1 postoperative review necessary after pars plana vitrectomy?

Alexander

Michaels

Newsom

2015

Eye

View full text Add to dashboard Cite

Purpose This study aimed to determine the proportion of patients requiring alteration in management based on the findings of the day-1 postoperative visit after pars plana vitrectomy, and to identify clinical characteristics that predict the need for unexpected intervention. Patients and methods A retrospective case note review was conducted of all patients who underwent pars plana vitrectomy and who then attended for review on the first postoperative day. All patients received routine prophylactic anti-glaucoma medication.Results Two hundred and seventy-three patients examined on day 1 following vitrectomy were studied. Indications for surgery included retinal detachment, epiretinal membrane, macular hole, vitreous haemorrhage, diabetic eye disease, and floaters. Twenty-gauge (20G) vitrectomy was performed in 124 eyes (45%); 23-gauge (23G) vitrectomy was performed in 149 eyes (55%). Phacoemulsification was performed concurrently in 51/273 (19%) eyes. Ten patients (3.7%) required unexpected intervention on day 1 owing to intraocular pressure (IOP) 430 (2/273), IOP o6 (5/273), or unexpected return to theatre for anterior chamber washout (3/273). There was no difference in intervention rate or day-1 IOP between 20G and 23G cases. Hypotony was less common if gas tamponade was used (χ 2 -test, Po0.001). Patients undergoing combined phacoemulsification and 20G vitrectomy were significantly more likely to require intervention on day 1 than patients undergoing 20G vitrectomy alone (15.0 vs 1.9%, P = 0.029, Fisher's exact test) but this was not the case for patients undergoing 23G vitrectomy (0 vs 4.2%, Fisher's exact test, P = 0.58). Conclusions The intervention rate on the first day after vitrectomy is low and day-1 postoperative review can be safely omitted in the majority of patients undergoing vitrectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is day-1 postoperative review necessary after pars plana vitrectomy?

Alexander

Michaels

Newsom

2015

Eye

View full text Add to dashboard Cite

show abstract

“…[1][2][3] It has been suggested that the 1-day postoperative intraocular pressure (IOP) check post routine uncomplicated phacoemulsification can be abandoned for a number of reasons. 1,[4][5][6][7] Some of these include the fact that new surgical complications are unlikely to be picked up on the first day, peak IOP may have already passed, economical constraints, improved postoperative outcomes and low complication rates. 1,4 However in patients with glaucoma or ocular hypertension (OHT), either this approach was not advocated, or it was recommended that prophylactic regimes against a raised IOP should be followed as investigated in other studies.…”

Section: Introductionmentioning

confidence: 99%

Is the 1-day postoperative IOP check needed post uncomplicated phacoemulsification in patients with glaucoma and ocular hypertension?

Gupta

Vernon

2015

Eye

View full text Add to dashboard Cite

Purpose To determine whether the 1-day postoperative intraocular pressure (IOP) check following routine uncomplicated phacoemulsification is necessary in patients with pre-existing glaucoma and ocular hypertension (OHT), if acetazolamide prophylaxis is used. To investigate the practice of UK glaucoma specialists in IOP rise prophylaxis and follow-up regimes.Patients and methods The IOP 1-day postoperatively was analysed against the last recorded IOP before phacoemulsification in a cohort of patients with glaucoma or OHT who underwent uncomplicated phacoemulsification cataract surgery between December 2009 and September 2012, where it was routine practice to give acetazolamide postoperatively. UK and Eire Glaucoma Society members were surveyed via an online questionnaire to analyse practice among UK glaucoma specialists. Results One hundred and seven eyes were studied: 99 with glaucoma and 8 with OHT. The mean IOP change was À 0.8 mm Hg with only two eyes measuring 430 mm Hg postoperatively (2%). Both these eyes received 750 mg acetazolamide. Eighteen (17%) eyes had an IOP rise of at least 30%. In the survey of practice there were 65 respondents. Twenty-one (32%) respondents did not use IOP prophylaxis. Only 17 (26%) of respondents routinely reviewed their patients 1-day postoperatively.Conclusion Our prophylactic acetazolamide regime does not completely eliminate the risk of an IOP 430 mm Hg on day 1 post routine phacoemulsification in glaucoma/ OHT patients. Patients with pre-existing glaucoma, despite acetazolamide prophylaxis, will require IOP management decisions on the first postoperative day after uncomplicated phacoemulsification surgery. UK expert practice is non-uniform with regard to IOP prophylaxis, and the 1-day review, and further discussion and formulation of consensus appears necessary.

show abstract

“…[1][2][3][4] Several studies have reported an early increase in IOP following phacoemulsification. [5][6][7] The amount of this increase is related to several factors including the type of the viscoelastic agent and different surgical techniques.…”

mentioning

confidence: 99%

Intraocular Pressure Changes Following Phacoemulsification

Karataş¹,

Yaycıoğlu²,

Canan³

et al. 2012

Turkiye Klinikleri J Med Sci

View full text Add to dashboard Cite

. Intraocular pressure values of preoperative and postoperative first day, first week and first month visits were recorded. Intraocular pressures over 22 mm Hg were considered as high IOP. Either anterior chamber decompression or antiglaucomatous medication was used to decrease the postoperative rise in IOP. Changes in IOP were analyzed using ANOVA. R Re es su ul lt ts s: : The mean preoperative IOP was 15.6±4.3 mmHg, which increased to 19.7±9.0 mmHg on the 1st day (p<0.001). The IOP decreased significantly to 12.7±4.5 mmHg at 1 st week, and 12.8±3.7 mmHg at 1 st month (p<0.001, both). In 249 (30.7%) eyes, high IOP was detected on the first day. In 114 (45.8%) of these eyes, IOP was reduced by anterior chamber decompression while in 73 (29.3%) eyes glaucoma medication was prescribed. At first month 13 (1.6%) eyes had high IOP. C Co on nc cl lu us si io on n: : Although, a rise in IOP remains a problem in the postoperative first day; both anterior chamber decompression and glaucoma medication seem to be effective and safe to overcome thiscondition. In short term, uneventful phacoemulsification and intraocular lens implantation results in a decrease in IOP.K Ke ey y W Wo or rd ds s: : Phacoemulsification; intraocular pressure; glaucoma Ö ÖZ ZE ET T A Am ma aç ç: : Fakoemülsifikasyonun göz içi basıncı (GİB) üzerindeki etkisinin ve cerrahi sonrası yüksek GİB olgularına yaklaşımın değerlendirilmesi. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Başkent Üniversitesi Adana Araştırma ve Uygulama Merkezi'nde komplikasyonsuz fakoemülsifikasyon cerrahisi geçiren 584 (330 erkek, 254 kadın) hastanın 812 gözüne ait veriler retrospektif olarak incelendi. Hastaların yaşları 26 ile 89 (65,5±9,8) arasında değişmekteydi. Ameliyat öncesi ve ameliyat sonrası 1. gün, 1. hafta ve 1. ay vizitlerindeki GİB değerleri kaydedildi. Yirmi iki üzerindeki değerler yüksek GİB olarak kabul edildi. Ameliyat sonrasında yüksek GİB değerlerini düşürmek için ön kamaradan boşaltma veya antiglokomatöz ilaç kullanımı tercih edildi. Göz içi basıncındaki değişimleri karşılaştırmak için ANOVA kullanıldı. B Bu ul lg gu ul la ar r: : Ameliyat öncesi ortalama GİB değeri 15,6±4,3 mmHg bulundu ve ameliyat sonrası 1. günde 19,7±9,0 mmHg'ya yükseldi (p<0,001). Göz içi basıncı, ameliyat sonrası 1. haftada 12,7±4,5 mmHg ve 1. ayda 12,8±3,7 mmHg olarak bulundu (her ikisi için de p<0,001). Ameliyat sonrası 1. günde 249 (%30,7) olguda yüksek GİB ölçüldü. Bu olguların 114'ünde (%45,8) GİB, ön kamaradan boşaltma yoluyla düşürülürken, 73 (%29,3) olguya antiglokomatöz ilaç reçete edildi. Birinci ayda 13 (%1,6) olguda yüksek GİB tespit edildi. S So on nu uç ç: : Ameliyat sonrası 1. günde göz içi basıncında tespit edilen yükselme sık görülen bir sorun olmakla beraber, hem ön kamaradan boşaltma, hem de antiglokomatöz ilaç kullanımı bu durumun üstesinden gelmek için etkin ve güvenli yöntemlerdir. Komplikasyonsuz fakoemülsifikasyon, ameliyat sonrasında kısa vadede GİB'de azalma sağlar.

show abstract

Phacoemulsification cataract surgery: is routine review necessary on the first post-operative day?

Abstract: Purpose To determine the value of routine review on the first post-operative day following phacoemulsification cataract surgery.

Cited by 58 publications

References 12 publications

Is day-1 postoperative review necessary after pars plana vitrectomy?

Is day-1 postoperative review necessary after pars plana vitrectomy?

Is the 1-day postoperative IOP check needed post uncomplicated phacoemulsification in patients with glaucoma and ocular hypertension?

Intraocular Pressure Changes Following Phacoemulsification

Contact Info

Product

Resources

About