Abstract:
Background: Cataract as a cause of reversible blindness have been shown to affect intraocular
pressure (IOP) as a result of change in the size of the opacified crystalline lens. Cataract
surgery is the only treatment option for cataract and is a commonly performed procedure
worldwide. Additionally, as the cataractous lens is removed the intraocular pressure may
remain the same, increase or decrease. Therefore, IOP measurements before and after cataract
surgery provide important information to ophthalmologist about IOP changes and the effect of
cataract surgery in cataract patients and those with co-existing glaucoma.
Objective: To determine the IOP changes following cataract surgery among cataract patients
attending MNH/CCBRT hospital.
Methodology: A hospital based prospective cross sectional study with consecutive sampling
technique was conducted between July 2020 and December 2020. A total number of 198
patients in 202 eyes of patients who were above 18years underwent cataract surgery at MNH
and CCBRT hospital. The IOP was measured using Icare rebound tonometer thrice before
cataract operation, postoperative IOP was measured after 24hrs and 6weeks of follow up. IOP
findings were recorded on a structured questionnaire. Data sheet was coded and the
information was entered and analyzed using the statistical package for social science (SPSS)
version 23, a P-value ≤ 0.05 was considered statistically significant.
Results: A total number of 178 patients with 180 eyes were analyzed of which 80(44.44%)
and 100(55.56%) underwent MSICS and phacoemulsification respectively. The overall mean
IOP preoperatively was 17.05+6.04mmHg which increased at 1st day post-operative period to
20.94+11.04mmHg p-value=0.00. There was a decline of IOP by 6th week post-operative
period 14.61+6.48mmHg and the difference was statistically significant with p-value=0.00. In
patients with co-existing glaucoma majority had high preoperative IOP but at 6weeks the
mean IOP for MSICS and phacoemulsification was 16.11+7.39mmHg and 17.92+7.13mmHg
respectively with p-value=0.643 in which there was no statistical difference.
Conclusion and Recommendations: There was a significant IOP reduction from baseline in
patient with normal as well as those with high preoperative IOP. Both MSICS and
phacoemulsification procedures showed an equal IOP reduction. Therefore, MSICS or
phacoemulsification may be considered as initial technique for IOP control.
