Factors influencing early post surgical ocular hypertension after phacoemulsification

Purpose: To evaluate factors influencing early post surgical ocular hyperte nsion after phacoemulsification. Methods: Records were collected for patients who had uncomplicated phacoemu lsification with IOL implantation in the bag. Aspiration of the viscoelasti c was performed at the conclusion of surgery. Patients with previous ocular surgery, high myopia, or glaucoma were excuded. Intraocular pressures were measured at six hours (+/-2) postoperatively. Following factors were analy sed: IOL material, PMMA, silicone, polyacrylic, ophthalmic viscosurgical device characteristics, ultrasonic duration, intracameral pilocarpine injection at the end of surgery. Results: 26% of the patients had an ocular pressure equal or higher than 21 mmHg. Among the factors we analysed, pilocarpine injection was the only one to produce significant decrease in postoperative ocular pressure. Comments: The acute postoperative IOP increase following phacoemulsificatio n is presumably the result of trabecular obstruction by viscoelastic materi al. However it can occure despite meticulous evacuation of viscoelastic, wi ch could be dependent upon the material's viscosity, and IOL material and d esign. Postoperative ocular hypertension is not related to ultrasonic durat ion. Intracameral injection of pilocarpine significantly reduces the incide nce of postoperative intraocular pressure increase. Conclusion: Early postoperative ocular hypertension can be observed with di fferent kinds of viscoelastics and IOL. Meticulous evacuation of viscoelast ic from anterior chamber, although necessary does not always prevent this e arly complication. Intracameral injection of pilocarpine can reduce its inc idence.