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First Author: S.Patel UK
Co Author(s): M. Dahl C. Feinbaum
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The volume of the monofocal IOL is much lower than the natural crystalline lens and coupled with the design of the IOL haptics, the iridocorneal angle and anterior chamber depth (ACD) will increase after unremarkable implantation. In theory, the chain of events should signal a fall in measured intra-ocular pressure (IOP) after routine cataract surgery. The aim of this study was, to assess IOP before and after unremarkable surgery and examine if any changes were associated with targeted post-op ACD.
Axess Medica, Malmoe, Sweden & Vision4You, Lund, Sweden
IOP was measured pre-op and post-op 4 weeks after drops were stopped, using a non-contact Icare tonometer by Icare, Finland. Five consecutive measurements were noted at each episode of IOP checking and the average was recorded. Standard biometry, using the IOL master by Carl Zeiss Meditec and A-scan ,was performed, and the IOL power was calculated. Surgical history: Washing of eyelids with chlorhexidine solution 0,5%, Blepharostate, 2.6mm limbal incision, Paracenteses, Viscoelastics in the anterior chamber, Capsulorhexis, emulsification of the lens nucleus with the phaco mouth tip and cortex removed by the I/A mouth piece. IOL injected in the bag. Viscoelastics removed and 1mg of Zinacef injected intracamerally. The incisions were hydrated until waterproof. The patients were enrolled in a consecutive routine case-by-case style. All surgical procedures were carried out by one surgeon using the same procedure.
Subjects consisted of 45 female & 35 males (80 eyes). The mean age was 73.2years (8,33), and range 51-92. Pre-op, mean IOP (ḟs.d) was 15.62 (3.89) reducing to 13.70(3.48) post op. The difference was significant (t-test, 2 tailed p=0.0012). Reporting just the significant associations only, linear regression revealed significant correlation between the change in IOP (?IOP= post-op pre-op) and pre-op IOP (x) as follows: ?IOP = 6.14 - 0515x (r= -0.565, n=80, p=<0.001) There was a weak but significant relationship (p=0.031) between post-op IOP and the targeted post-op anterior chamber depth (ACD)
The fall in measured IOP may be due to a combination of several factors including an increase in ACD. Interestingly, the results suggest that, when pre-op IOP is greater than 12mmHg, we can expect post-op IOP to fall. However, when pre-op IOP is below 12mmHg, we can expect post-op IOP to increase.