Early Intraocular Pressure Elevation After Cataract Surgery in Healthy Eyes

Objective: To determine the frequency of IOP elevation following cataract extraction in early postoperative period and its association with age and type of surgery. Methods: This was an observational study conducted at department of ophthalmology, MTI-Hayatabad Medical Complex, Peshawar from October 2022 to April 2024. Patients undergoing cataract surgery, age 50-80 years of either gender with no other ocular comorbidity were recruited. The frequency of elevated intraocular pressure (IOP) of > 30 mmHg within 24 hours after surgery was determined. The IOP spike was stratified according to gender, age and type of cataract surgery. Results: A total of 171 eyes of 171 participants were recruited in this study. Mean age of the participants was 62.92±7.78 years and 107 (62.6%) were males. The mean preoperative IOP was 14.05±4.26mmHg while the mean postoperative IOP was 15.94±5.19mmHg. Five (2.9%) participants had IOP elevation of more than 30mmHg within 24 hours of surgery. Type of surgeries performed were extracapsular cataract extraction (ECCE) in 23 (13.4%), manual small incision cataract surgery (MSICS) in 58 (33.9%) and phacoemulsification in 90 (52.6%) participants. The early postoperative IOP was significantly less in phacoemulsification 0 (0%) group as compared to MSICS (n=4, 80%) and ECCE (n=1, 20%) group (p=0.047). Conclusion: The frequency of IOP elevation within 24 hours of cataract surgery with IOL implantation in healthy Asian eyes was low. Older age and MSICS have more risk of postoperative IOP spikes.