Intraocular pressure on the first postoperative day as a prognostic indicator in phacoemulsification combined with deep sclerectomy

Abstract

Purpose: To study the intraocular pressure (IOP) as a prognostic indicator on the first day after combined phacoemulsification and nonpenetrating deep sclerectomy.

Setting: Ramón y Cajal Hospital, Madrid, Spain.

Methods: This retrospective study included 70 eyes of 70 patients who had combined phacoemulsification-nonpenetrating deep sclerectomy with a reticulated hyaluronic acid implant. Visual acuity, IOP, and slitlamp examinations were performed preoperatively and 1 and 7 days and 1, 3, 6, 12, and 24 months postoperatively. A split point of 9.0 mm Hg on the first postoperative day was used. Success probability analysis was performed using a Kaplan-Meier survival curve. The need for medication and postoperative neodymium:YAG goniopuncture was also recorded.

Results: The mean preoperative IOP was 22.5 mm Hg +/- 5.2 (SD). The mean postoperative IOP was 11.6 +/-8.1 mm Hg, 16.4 +/- 4.7 mm Hg, and 17.0 +/- 5.3 SD mm Hg at 1 day, 12 months, and 24 months, respectively. A greater success rate was observed in terms of survival (P = .006, log rank test) in patients with an IOP of 9 mm Hg or less on the first postoperative day; these patients also had a significantly reduced need for glaucoma treatment (P = .015) and goniopuncture (P = .009).

Conclusion: An IOP of 9 mm Hg or less on the first postoperative day might serve as a positive prognostic indicator in combined phacoemulsification with deep sclerectomy.