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Effect of simulated dynamic intraocular pressure on retinal thickness measured by optical coherence tomography after cataract surgery

Author(s): Ding Chen | Jun Zhu | Jin Li | Xi-Xia Ding | Fan Lu | Yun-E Zhao

Journal: International Journal of Ophthalmology
ISSN 2222-3959

Volume: 5;
Issue: 6;
Start page: 687;
Date: 2012;
Original page

Keywords: intraocular pressure | retina | optical coherence tomography | phacoemulsification

AIM: To investigate the effect of simulated dynamic intraocular pressure (SDIOP) during uncomplicated phacoemulsification on postoperative macular and peripapillary retinal nerve fiber layer (RNFL) thickness.METHODS: Macular and RNFL thicknesses in one eye of patients (n=30) undergoing uncomplicated phacoemulsification were measured by optical coherence tomography preoperatively and 1 week postoperatively. The best-corrected visual acuity, SDIOP, irrigation time (IT), effective phacoemulsification time, entire surgical duration, blood pressure, and heart rate were recorded.RESULTS: The mean SDIOP and IT was (74.9 ± 27.4)cmH2O and (178.4 ± 21.6) seconds respectively. We divided our patients into two groups based upon IT with greater than 90cmH2O (P>90IT). In Group A (n=14), the P>90IT was greater than the mean P>90IT, and in Group B (n=16), the P>90IT was less than the mean P>90IT. For all patients there was a significant increase in macular thickness one week after cataract surgery (P=0.001). While the RNFL thickness tended to increase, the change was not significant. The postoperative macular thickness of Group A, (277.8 ± 13.7)μm, was significantly thicker than that of Group B, (267.9 ± 15.0)μm (P=0.004). The postoperative peripapillary RNFL thickness of Group A, (96.8 ± 10.8) μm, was not significantly different from Group B. For Group A, the change in macular thickness was positively correlated with P>90IT (R2=0.524, P=0.02). There was no statistical difference in postoperative visual acuity between Groups A and B. CONCLUSION: After uncomplicated phacoemulsification, increased macular thickness is associated with the IT under high SDIOP. The effect of high SDIOP is limited to the sub-clinical level.
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