INTRAOCULAR-PRESSURE RISE AFTER PHACOEMULSIFICATION WITH POSTERIOR CHAMBER LENS IMPLANTATION - EFFECT OF PROPHYLACTIC MEDICATION, WOUND CLOSURE, AND SURGEONS EXPERIENCE

Aims-A prospective clinical trial was carried out to evaluate the effe ct of prophylactic medication, the technique of wound closure, and the surgeon's experience on the intraocular pressure rise after cataract extraction. Methods-In 100 eyes, the intraocular pressure was measured before as well as 2-4, 5-7, and 22-24 hours after phacoemulsification and posterior chamber lens implantation. Each of 25 patients received either 1% topical apraclonidine, 0 . 5% topical levobunolol, 500 mg o ral acetazolamide, or placebo. Forty four eyes were operated with scle rocorneal sutureless tunnel and 56 eyes with corneoscleral incision an d suture. Sixty three operations were performed by experienced surgeon s (more than 300 intraocular operations) and 37 by inexperienced surge ons (less than 200 intraocular operations). Results-The pressure incre ase from baseline to the maximum 5-7 hours after surgery did not diffe r significantly (p = 0 . 8499) for apraclonidine (9 . 5 mm Hg), levobu nolol (7 . 2 mm Hg), acetazolamide (7 . 8 mm Hg), and placebo (8 . 6 m m Hg). The increase was significantly (p = 0 . 0095) lower in eyes wit h corneoscleral tunnel (5 . 5 mm Hg) than in eyes with corneoscleral s uture (10 . 5 mm Hg) and significantly (p = 0 . 0156) lower for experi enced (6 . 6 mm Hg) than for inexperienced surgeons (11 . 2 mm Hg). Co nclusions-The intraocular pressure rise after phacoemulsification and posterior chamber lens implantation depends the technique of wound the surgeon's experience. Compared with these two factors, the effect of prophylactic medication can be neglected.