Early transient intraocular pressure spike after cataract surgery in highly myopic cataract eyes and associated risk factors.

PURPOSE: To investigate the incidence of the early transient intraocular pressure (IOP) spike after cataract surgery in eyes with highly myopic cataract (HMC) and associated risk factors.

METHODS

Consecutive patients treated with phacoemulsification were recruited. IOP was measured before and 1 day, 3 days, 1 week and 3 months after surgery. Axial length (AL) and anterior chamber depth (ACD) were recorded, and optic disc tilt, rotation and beta-zone peripapillary atrophy (β-PPA) were measured from fundus photographs taken 1 week after surgery. Backward stepwise multiple linear regression was used to investigate the risk factors for early transient IOP spike in the HMC group.

RESULTS

Finally, 94 eyes of 94 HMC patients and 67 eyes of 67 age-related cataract (ARC) controls were included in analysis. The incidence of early IOP spike was 10% in the ARC group and 28% in the HMC group (OR=3.277, p<0.05) at 1 day after surgery. In the HMC group with IOP spikes, more males were seen and affected eyes showed longer AL, shallower ACD, greater optic disc tilt, and larger β-PPA than those without (all p<0.05). Multivariate analysis showed that sex, AL, ACD, and area of β-PPA were significantly associated with an early transient IOP spike in HMC eyes (all p<0.05).

CONCLUSIONS

Highly myopic eyes are more susceptible to early transient IOP spike after cataract surgery, and male sex, longer AL, shallower ACD, and greater β-PPA are associated risk factors.

CLINICAL TRIAL REGISTRATION NUMBER: NCT02182921.