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Impact on Visual Outcome and Complications in Postoperative Raised Intaocular Pressure (IOP) Patients of Cataract Surgery at a Tertiary Care Hospital
Background and Objectives: Intraocular pressure increase frequently occurs in the early period after cataract Extraction. Some operated patients of cataract surgery, however, may experience pain, corneal oedema, glaucomatous nerve damage, or anterior ischemic optic neuropathy. Causes of this elevation in IOP include retained lens material, postoperative inflammation, and retention of viscoelastic substances within the anterior chamber. Postoperative increases in IOP are transient and benign. It is therefore important to monitor continuously the effect of new cataract surgical techniques on postoperative IOP as well as the impact of increased IOP on visual outcomes. Materials and Methods: Out of total patients who underwent cataract surgery at our institute 1311 had increase in intra-ocular pressure during November 2015 to October 2017. Out of those total number of 150 patients were selected at random after taking inclusion and exclusion criteria into consideration. Cases of increased intraocular pressure post cataract surgery were included in study were examined in full on observations documented on post-operative Day 1 then till discharge, after 7 days, 1 month and 3 months. Results: Thus, incidence of increase in intraocular pressure after cataract surgery in our institute is 24.15%. In the present study acute postoperative inflammation was the most common cause (39%) of increase in intraocular pressure. Other common causes were vitreous obstruction following posterior capsular rupture (27%), retained visco-elastic substances (22%). Least common cause (2%) in our study was retained lenticular fragments. Conclusion: Maximum patients (53%) with raised intra-ocular pressure post-cataract surgery had pressures in the range of 21 to 30 mm Hg. Majority (64%) had post-operative day 1 best corrected visual acuity between FC 1 m to 20/200. No patient had BCVA 20/20 to 20/40. Patients with increased IOP more than 40 mm Hg were associated poor visual outcome compared to patients with less IOP rise. In maximum patients (86%), intra-ocular pressure became normal (<21mm hg) within 7 days.
Corneal Edema, Goldmann Applanation Tonometer, Intraocular pressure.
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