Raised Intraocular Pressure Following Phacoemulsification; A Comparative Study with Two Different Viscoelastic

Raised Intraocular Pressure Following Phacoemulsification

Authors

  • Ahmed Jamal Khan Ophthalmology, Hayatabad Medical Complex, Peshawar.
  • Maqbool-ur Rehman Ophthalmology, Khyber Teaching Hospital, Peshawar
  • Awais Ashraf Department of Ophthalmology, Multan Medical and Dental College, Multan. University of Health Sciences, Lahore. Pakistan
  • Muhammad Sajid Khan Ophthalmologist, Hayatabad Medical Complex, Peshawar
  • Ubaid Ullah Ophthalmology, Hayatabad Medical Complex, Peshawar
  • Aeeza Malik Multan Medical and Dental College

DOI:

https://doi.org/10.54393/pjhs.v3i07.401

Keywords:

Intraocular Pressure, Methylcellulose, Sodium Hyaluronate, Phacoemulsification, Viscoelastic Substance

Abstract

The new modalities in surgical phacoemulsification techniques are intended to restore the visual acuity and have minimized postoperative astigmatism. Objective: To evaluate the difference in the raised intraocular pressure after phacoemulsification and insertion of an intraocular lens using 2% hydroxymethyl cellulose and 1% sodium hyaluronate as viscoelastic. Methods: This group comparative study was performed in the Department of Ophthalmology, Khyber Teaching Hospital, Peshawar for six months. A thorough slit lamp examination was executed to confirm intraocular inflammation or proof of prior intraocular surgery. For glaucoma, Gonioscopy was performed along with proper fundus examination. Patients in Group 1 received 2% Hydroxymethyl Cellulose while in Group 2 patients received 1% Sodium Hyaluronate as viscoelastic. No pressure lowering drug was used and mean intraocular pressure was calculated using Goldman Applanation Tonometer. Intraocular pressure was measured preoperatively and then after 6, 12 and 24 hours and then after one week of surgery. Results: In Group 1, mean age was 65 ± 8.5 and mean Pre Op IOP was 13.1 ±  2.1. Mean Postop IOPs were 13.8, 14.2, 15.1 and 17.5 at 6, 12, and 24 hours and after 1 week respectively. In Group 2, mean age was 62.7 ± 8.3 and mean Preop IOP was 13.2 ± 2.3.  Mean Postop IOPs were 13.5, 13.9, 15.1 and 15.9 at 6, 12, and 24 hours and after 1 week respectively. Conclusions: Mean intraocular pressure rise was significantly greater at one week after phacoemulsification and insertion of an intraocular lens using 2% hydroxymethyl cellulose as viscoelastic.

References

Astbury NJ. The Royal College of Ophthalmologists Cataract Surgery Guidelines: what can patients see with their operated eye during cataract surgery?. Eye. 2003 Mar; 17(2): 285-6. doi: 10.1038/sj.eye.6700282

Singh K, Misbah A, Saluja P, Singh AK. Review of manual small-incision cataract surgery. Indian Journal of Ophthalmology. 2017 Dec; 65(12): 1281-88. doi: 10.4103/ijo.IJO_863_17

Asena BS. Visual and refractive outcomes, spectacle independence, and visual disturbances after cataract or refractive lens exchange surgery: comparison of 2 trifocal intraocular lenses. Journal of Cataract and Refractive Surgery. 2019 Nov; 45(11): 1539-46. doi: 10.1016/j.jcrs.2019.06.005

Remington LA and Goodwin D. Clinical Anatomy and Physiology of the Visual System E-Book. Elsevier Health Sciences; 2021 Jun 25.

Toris CB, Gagrani M, Ghate D. Current methods and new approaches to assess aqueous humor dynamics. Expert Review of Ophthalmology. 2021 May; 16(3): 139-60. doi: 10.1080/17469899.2021.1902308

Mahsud H, Iqbal S, Khalid K, Khan MD, Ullah H. Comparison of effect of sodium hyaluronate and hydroxy propyl methylcellulose on intraocular pressure after cataract surgery. Gomal Journal of Medical Sciences. 2015 Mar;13(1): 1-4.

Özcura F and Çevik S. Hydroimplantation versus viscoimplantation: comparison of intraocular lens implantation with and without ophthalmic viscoelastic device in phacoemulsification. Romanian Journal of Ophthalmology. 2018 Oct; 62(4): 282-7. doi: 10.22336/rjo.2018.43

Van Ooteghem MM. Formulation of ophthalmic solutions and suspensions. Problems and advantages. In Biopharmaceutics of ocular drug delivery. CRC Press. 2019 Aug: 27-42.

Yildirim TM, Auffarth GU, Son HS, Khoramnia R, Munro DJ, Merz PR. Dispersive viscosurgical devices demonstrate greater efficacy in protecting corneal endothelium in vitro. BMJ Open Ophthalmology. 2019 Feb; 4(1):e000227. doi: 10.1136/ bmjophth-2018-000227

Reddy JC, Vaddavalli PK, Sharma N, Sachdev MS, Rajashekar YL, Sinha R, et al. A new normal with cataract surgery during COVID-19 pandemic. Indian Journal of Ophthalmology. 2020 Jul; 68(7): 1269-76. doi: 10.4103/ijo.IJO_1528_20

Storr‐Paulsen A, Nørregaard JC, Farik G, Tårnhøj J. The influence of viscoelastic substances on the corneal endothelial cell population during cataract surgery: a prospective study of cohesive and dispersive viscoelastics. Acta Ophthalmologica Scandinavica. 2007 Mar; 85(2): 183-7. doi: 10.1111/j.1600-0420.2006.00784.x

Brogan K, Diaper CJ, Rotchford AP. Cataract surgery refractive outcomes: representative standards in a National Health Service setting. British Journal of Ophthalmology. 2019 Apr; 103(4): 539-43. doi: 10.1136/bjophthalmol-2018-312209

Malvankar-Mehta MS, Fu A, Subramanian Y, Hutnik C. Impact of ophthalmic viscosurgical devices in cataract surgery. Journal of Ophthalmology. 2020 Oct; 2020. doi: 10.1155/2020/7801093

Kalode VB and Sune P. Comparative study of safety and efficacy of dispersive versus cohesive ophthalmic viscosurgical devices in cataract surgery after phacoemulsification. Journal of Datta Meghe Institute of Medical Sciences University. 2020 Oct; 15(4):555-64. doi: 10.4103/jdmimsu.jdmimsu_239_20

Wijesinghe HK, Puthuran GV, Ramulu PY, Ponnat AK, Reddy MM, Mani I, et al. Intraocular Pressure Control Following Phacoemulsification in Eyes with Pre-existing Aurolab Aqueous Drainage Implant. Journal of Glaucoma. 2022 Jun; 31(6): 456-61. doi: 10.1097/IJG.0000000000001946

Kelkar A, Kelkar J, Mehta H, Amoaku W. Cataract surgery in diabetes mellitus: a systematic review. Indian Journal of Ophthalmology. 2018 Oct; 66(10):1401-10. doi: 10.4103/ijo.IJO_1158_17

Gerberich AJ and Ipema HJ. A primer on ocular viscosurgical devices. American Journal of Health-System Pharmacy. 2021 Nov; 78(22): 2020-32. doi: 10.1093/ajhp/zxab228

Bardoloi N, Sarkar S, Pilania A, Das H. Pure phaco: phacoemulsification without ophthalmic viscosurgical devices. Journal of Cataract and Refractive Surgery. 2020 Feb; 46(2):174-8. doi: 10.1097/j.jcrs.0000000000000054

Payal AR, Sola-Del Valle D, Gonzalez-Gonzalez LA, Cakiner-Egilmez T, Chomsky AS, Vollman DE, et al. American Society of Anesthesiologists classification in cataract surgery: results from the ophthalmic surgery outcomes data project. Journal of Cataract and Refractive Surgery. 2016 Jul; 42(7): 972-82. doi: 10.1016/j.jcrs.2016.04.032

Lin CC, Rose-Nussbaumer JR, Al-Mohtaseb ZN, Pantanelli SM, Steigleman III WA, Hatch KM, et al. Femtosecond Laser-Assisted Cataract Surgery: A Report by the American Academy of Ophthalmology. Ophthalmology. 2022 May; 129(8): 946-54. doi: 10.1016/j.ophtha.2022.04.003

Adamus G, Champaigne R, Yang S. Occurrence of major anti-retinal autoantibodies associated with paraneoplastic autoimmune retinopathy. Clinical Immunology. 2020 Jan; 210: 108317. doi: 10.1016/j.clim.2019.108317

Borkenstein AF, Borkenstein EM, Malyugin B. Ophthalmic Viscosurgical Devices (OVDs) in Challenging Cases: a Review. Ophthalmology and Therapy. 2021 Dec; 10(4): 831-43. doi: 10.1007/s40123-021-00403-9

Murueta-Goyena A and Canadas P. Visual outcomes and management after corneal refractive surgery: A review. Journal of Optometry. 2018 Apr; 11(2): 121-9. doi: 10.1016/j.optom.2017.09.002

Watanabe I, Suzuki K, Nagata M, Matsushima H. Clinical Functionality of Dispersive OVDs: Improvement of One of the Properties of 3% Hyaluronic Acid and 4% Chondroitin Sulfate Combination. Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan. 2022 Jan; 142(4): 401-11. doi: 10.1248/yakushi.21-00208

Brandsdorfer A and Kang JJ. Improving accuracy for intraocular lens selection in cataract surgery. Current Opinion in Ophthalmology. 2018 Jul; 29(4): 323-7. doi: 10.1097/ICU.0000000000000493

Verma L, Agarwal A, Dave VP, Honavar SG, Majji AB, Lall A, et al. All India Ophthalmological Society (AIOS) Task Force guidelines to prevent intraocular infections and cluster outbreaks after cataract surgery. Indian Journal of Ophthalmology. 2022 Feb; 70(2): 362-8. doi: 10.4103/ijo.IJO_94_22

Downloads

Published

2022-12-31
CITATION
DOI: 10.54393/pjhs.v3i07.401
Published: 2022-12-31

How to Cite

Jamal Khan, A. ., Rehman, M.- ur, Ashraf , A., Sajid Khan, M. ., Ullah, U. ., & Malik, A. (2022). Raised Intraocular Pressure Following Phacoemulsification; A Comparative Study with Two Different Viscoelastic: Raised Intraocular Pressure Following Phacoemulsification. Pakistan Journal of Health Sciences, 3(07), 93–97. https://doi.org/10.54393/pjhs.v3i07.401

Issue

Section

Original Article

Plaudit