Impact of residual ophthalmic viscosurgical device behind intraocular lens on postoperative intraocular pressure and refractive outcomes in cataract surgery.

PURPOSE: This study aims to quantify the residual ophthalmic viscosurgical device (OVD) behind the intraocular lens (IOL) following cataract surgery and evaluate its impact on intraocular pressure (IOP) and refractive changes during the postoperative period. Additionally, it examines OVD regression and associated risk factors.

DESIGN

Prospective Clinical Trial.

METHODS

Thirty eyes of thirty patients who underwent uncomplicated cataract surgery with monofocal posterior chamber IOL implantation were included. Postoperative assessments were conducted on days 1, 3, 5, 7, 10, and 14. Using anterior segment OCT, OVD thickness behind the IOL was measured, and correlations were analyzed between OVD reduction, IOP (via non-contact tonometry), and refractive error changes. Risk factors examined included age, gender, laterality, pseudoexfoliation (psx), surgeon experience, cataract hardness, biometric data, and phacoemulsification parameters.

RESULTS

On day 1, mean OVD thickness was 215.7 ± 92.7 µm. A significant decrease in OVD was noted with each follow-up, with complete resorption by day 10 (p = 0.01). Initial IOP was 18.0 ± 3.3 mmHg, showing a notable reduction over time (p = 0.01). A positive correlation was observed between OVD reduction and IOP decrease from days 1 to 3 (p = 0.01, r = 0.581) and days 1 to 5 (p = 0.017, r = 0.432). Additionally, a significant association was found between OVD reduction and myopic shift from days 3 to 5 (p = 0.014, r = 0.444). Patients with thinner lenses had higher residual OVD on day 1 (p = 0.01, r = - 0.504).

CONCLUSIONS

Residual OVD behind the IOL may elevate IOP and cause refractive changes, emphasizing the need for thorough OVD removal and close postoperative monitoring, especially in patients with thinner lenses.