Effect of Cataract Surgery on Intraocular Pressure among Adult Patients Attending Tertiary Eye Hospitals in Dar Es Salaam

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.