Role Of Optic Nerve Head Characteristics In Predicting Intraocular Pressure Spike After Cataract Surgery In Highly Myopic Eyes

Eye & ENT Hospital of Fudan University

Consecutive highly myopic patients who underwent cataract surgery were enrolled. IOP was measured preoperatively, and 1 day and 3 days postoperatively. Characteristics of ONH including optic disc area and tilt ratio, lamina cribrosa(LC) thickness and depth, and LC defect were measured with enhanced depth imaging optical coherence tomography. Factors influencing LC defect and early IOP spike were investigated using multivariate stepwise binary logistic regression.

200 eyes of 200 patients were included in analysis. Of all included eyes, 106/200 (53.00%) eyes had optic disc tilt, and 28/200 (14.00%) eyes had LC defect. Multivariate analysis demonstrated that female patients with larger optic disc area and deeper LC tend to have LC defect (P<0.05). Compared to the optic disc tilt absent group, higher postoperative IOP, IOP change, and incidence of IOP spike after cataract surgery occurred in the optic disc tilt present group (allP< 0.05). However, the LC defect present group had converse results in these parameters compared to the LC defect absent group (P<0.05). Multivariate analysis demonstrated that presence of LC defect and thicker LC were the protective factors for early IOP spike (P<0.05).

Female patients with larger optic disc area and deeper LC tend to have presence of LC defect, which was the protective factor for early IOP spike in highly myopic eyes.