Purpose: To determine the pattern of intraocular pressure (IOP) change postoperatively and its bearing on the timing of postoperative review.
Setting: Ophthalmology department of a district general hospital, Northamptonshire, England.
Methods: One hundred eyes of 100 consecutive patients having uneventful phacoemulsification were included in this study. The IOP was measured preoperatively and 2 hours, 1 day, and 1 week postoperatively. The IOP readings were statistically analyzed using the Fisher exact probability test.
Results: From 1 week before surgery, there was a mean rise in IOP of 8.14 mm Hg 2 hours after surgery followed by a mean fall of 5.18 mm Hg at 24 hours (next-day review). The mean fall in IOP at 1 week was 2.94 mm Hg. Ten percent of patients had an IOP greater than or equal to 35 mm Hg 2 hours postoperatively and required oral IOP-lowering agents. All patients had an IOP lower than 35 mm Hg at the next-day review. At 1 day, 18.6% of patients had a higher IOP than at 2 hours; however, the mean IOP was 21.39 mm Hg.
Conclusions: The results show it is safe to review patients 2 hours after uneventful phacoemulsification and omit the next-day review. This enhances patient acceptance of true day-case cataract surgery as it eliminates the need for an inpatient stay and transport on the following day. It also improves utilization of hospital resources. A larger study will help confirm the conclusions of this study.