Comparison Of Cataract Surgery Outcomes In Patients With Supranormal Intraocular Pressure (20 Mmhg) Versus Elevated Pressure (50 Mmhg)

To evaluate preoperative and postoperative (one week after surgery) endothelial cell counts, postoperative visual acuity, and corneal oedema in cataract surgeries performed at supranormal intraocular pressure (20 mmHg) compared to those with higher pressure (50 mmHg)

Department of Ophthalmology of AHEPA University hospital and Clinic of Northern Greece

This prospective study involved 36 patients, divided into two groups of 18 each. All surgeries were performed by a single experienced surgeon of Ahepa University hospital using the Centurion Vision System (Alcon) phacoemulsification system with a 2.2 mm central incision and bimanual technique under topical anaesthesia with drops. An acrylic posterior chamber intraocular lens was implanted in all cases. Surgeries were uneventful. Endothelial cell counts, postoperative visual acuity, and central corneal thickness were assessed preoperatively and one month postoperatively

The group with lower intraoperative pressure (20 mmHg) demonstrated an 8% higher endothelial cell count postoperatively, 6%  fewer corneal oedema, better visual acuity and reduced corneal striae compared to the group with intraoperative higher pressure (50 mmHg)

Performing cataract surgery at a supranormal intraocular pressure of 20 mmHg is a safe method yielding excellent outcomes. This technique, when executed by experienced surgeons with appropriately modified fluidics, may protect patients with co-existing eye disease or complicating co-morbidity that could be adversely affected by higher intraoperative pressures or prevent exacerbation of existing abnormalities (e.g., floppy iris syndrome). However, further studies are necessary to substantiate these findings