IOP Elevation After Cataract Surgery: Results for Residents and Senior Staff at Henry Ford Health System

Document Type

Article

Publication Date

10-1-2016

Publication Title

Journal of glaucoma

Abstract

PURPOSE: To determine the incidence of intraocular pressure (IOP) elevation on postoperative day 1 (POD1) after cataract surgery performed by resident surgeons compared with attending surgeons and to examine the influence of associated variables on the incidence of postoperative IOP elevation.

PATIENTS AND METHODS: Retrospective review of 2472 consecutive 2.2 to 2.8 mm temporal clear corneal cataract extractions by phacoemulsification performed by either residents or attending surgeons at Henry Ford Health System. Fellow eyes were excluded, resulting in 1847 eyes. IOP measurements of >40, >30, and >23 mm Hg were noted along with incremental IOP elevations of ≥10 and 20 mm Hg over preoperative/baseline IOP. Associated variables included: age, sex, diabetes mellitus, hypertension, glaucoma, glaucoma suspect, uveitis, prior ocular trauma, and vitreous loss at surgery.

RESULTS: Resident-performed cataract surgery was associated with statistically significant higher rates of IOP elevation in all categories and in all clinical situations known to be associated with postoperative IOP spike, that is, vitreous loss at surgery, prior ocular trauma, and preexisting glaucoma.

CONCLUSIONS: The incidence of postoperative day 1 IOP elevation after phacoemulsification performed by resident surgeons was 2 to 5 times that of experienced cataract surgeons. Variables including vitreous loss at surgery, prior ocular trauma, preexisting glaucoma, glaucoma suspect status, and male sex were significant contributors. Consideration for prophylactic IOP lowering is advised in high-risk patients.

Medical Subject Headings

Adolescent; Adult; Aged; Aged, 80 and over; Cataract; Education, Medical, Graduate; Female; Humans; Incidence; Internship and Residency; Intraocular Pressure; Male; Medical Staff, Hospital; Middle Aged; Ocular Hypertension; Ophthalmology; Phacoemulsification; Postoperative Complications; Retrospective Studies

PubMed ID

27027228

Volume

25

Issue

10

First Page

802

Last Page

806

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