Effect of Phacoemulsification on Intraocular Pressure in Cataract Patients Attending a Tertiary Care Centre in Kerala- A Retrospective Cohort Study

Abstract

Introduction: Cataract is the leading cause of preventable blindness worldwide. It is caused by the degeneration and opacification of the lens fibres. Phacoemulsification is the current treatment modality available for cataract. However, there is a possibility of an increase in the anterior chamber depth after phacoemulsification. This occurs as a result of the removal of the bulky lens matter and implantation of a thin intraocular lens, thereby reducing the intraocular pressure. Aim: To compare the preoperative and postoperative Intraocular Pressure (IOP) changes and the factors associated with intraocular pressure changes among patients who underwent phacoemulsification in a Tertiary Care Centre in Kerala. Materials and Methods: A retrospective cohort study was carried out among 610 patients, who underwent phacoemulsification surgery from January 1st, 2017 to December 31st, 2017. Using a checklist, the following data such as age, sex, Date of Surgery, Last recorded preoperative intraocular pressure of both eyes, First recorded Postoperative intraocular pressure of both eyes any time after 3 months, Axial length, Grade of cataract and comorbidities like diabetes, hypertension, dyslipidaemia, glaucoma and Coronary Artery Disease (CAD) was obtained from the hospital Information System. Data collected was entered into an MS Excel and was analysed using SPSS version 20. Frequency and percentages were calculated and association assessed using Chi-square test. Paired t-test was applied to find the mean changes in the IOP levels and p-value was ≤0.05, thus significant. Results: It was observed that there was a mean reduction of 7.907 mmHg in ocular hypertensives when compared to ocular normotensives following phacoemulsification. This finding was found to be statistically significant (p-value <0.001). There was association between grade of cataract and change in IOP which was significant with a p-value of 0.031. Conclusion: Phacoemulsification is the treatment of choice in patients with cataract. In the study, it was found that ocular hypertensives who underwent phacoemulsification had a significant drop in intraocular pressure post-surgery. Phacoemulsification can be employed in patients who have both ocular hypertension and cataract. This procedure can improve vision and in addition to having a positive effect on IOP reduction.