Ocular hypertension after cataract surgery: A comparison of three surgical techniques and two viscoelastics

BACKGROUND AND OBJECTIVE: To evaluate the incidence and course of ocular hypertension after cataract surgery using two different viscoelastics and three different surgical techniques. PATIENTS AND METHODS: Thirty-six patients who had undergone extracapsular cataract extraction (ECCE), 22 who had undergone phacoemulsification (PHACO), and 16 who had undergone manual nucleofragmentation (MNF) were randomized to receive either a low-viscosity viscoelastic (LVV) or a high-viscosity viscoelastic (HVV) intraoperatively. Postoperative evaluation included anamnesis, intraocular pressure (IOP) measurement, and slit-lamp examination at 3, 6, 24, and 72 hours and 7 days. RESULTS: The incidence of increased IOP over baseline after cataract surgery was 74.3%. The study of both viscoelastics revealed a trend for higher IOP during the first 24 hours for patients who received HVV (P <.05). Greater differences were observed when comparing surgical techniques. Small-incision techniques showed higher mean postoperative IOPs, and more severe hypertensions (PHACO 5/22 [22.7%] and MNF 2/16 [12.5%] vs ECCE 3/36 [8.3%]) (P <.05). CONCLUSIONS: Ocular hypertension is a frequent postoperative complication. It is slightly more common when using HVV. Small-incision techniques show higher mean postoperative IOPs and more severe hypertensions.