Immediate changes in intraocular pressure after clear corneal micro-incision versus small-incision cataract surgery.

Abstract

We sought to examine changes in intraocular pressure (IOP) in the immediate period after clear corneal micro-incision cataract surgery (MICS) and after small-incision cataract surgery (SICS). Sixty-eight eyes of 34 patients scheduled for coaxial phacoemulsification were randomized into one of two groups: (a) eyes that were to undergo a 2.0-mm MICS, and (b) a 2.65-mm SICS. At the conclusion of surgery, the IOP was adjusted to the range between 15-40mmHg with stromal hydration. The IOP was measured using a rebound tonometer preoperatively, at the conclusion of surgery, and at 3, 6, 9, 12, and 15min postoperatively. The Seidel test and anterior segment-optical coherence tomography were performed at 20min postoperatively. Mean IOP at the conclusion of surgery was 27.7±4.7mmHg in the MICS group and 29.7±5.1mmHg in the SICS group (p=0.1239). In both groups, mean IOP decreased to the preoperative level within 9min postoperatively and did not change significantly for up to 15min. Mean IOP was similar between the MICS and SICS groups throughout the observation period (p≥0.1239). Hypotony (≤10mmHg), positive Seidel test, and loss of wound coaptation were not detected in all eyes. After adjusting the IOP to a relatively high level at the conclusion of surgery, the IOP decreased within 9min and was stable within 15min without hypotony. The IOP was comparable between eyes after MICS and SICS, and both incisions virtually closed within 20min postoperatively.