Revisiting early postoperative follow-up after phacoemulsification

J Cataract Refract Surg. 2002 Jan;28(1):100-8. doi: 10.1016/s0886-3350(01)00994-4.


Purpose: To determine whether postoperative evaluation of routine phacoemulsification can be safely and effectively performed on the day of surgery and 4 days postoperatively and evaluate the incidence and management of early intraocular pressure (IOP) elevations 3 to 7 hours postoperatively in patients with or without glaucoma.

Setting: Community-based hospital.

Methods: This retrospective series comprised 465 consecutive patients who had phacoemulsification and intraocular lens implantation. All patients had postoperative follow-up on the day of surgery (3 to 7 hours postoperatively) and at 4 days. Patients were classified into 2 groups: nonglaucoma (NG), 396 patients; and glaucoma (GL), 69 patients. The main outcome measures were the incidence and management of postoperative complications including IOP spikes, wound leaks, uveitis, and endophthalmitis.

Results: Three to 7 hours postoperatively, 73 NG (18.4%) and 32 GL (46.4%) patients had IOP elevations greater than 28 mm Hg, a significant change from baseline (P <.0001). Fourteen NG (3.6%) and 13 GL (18.8%) patients had IOP elevations greater than 40 mm Hg (P <.0001). Significant IOP elevations were effectively managed with a paracentesis with or without short-term antiglaucoma medications on the day of surgery, with 75 NG (18.9%) and 39 GL (56.5%) patients requiring IOP intervention. There were no IOP elevations greater than 21 mm Hg on the next day or at 4 days. There were no complications that were missed at the same-day evaluation that may have been identified at the 1-day postoperative visit.

Conclusions: The results indicate that after routine phacoemulsification, patients can be safely and effectively reviewed on the day of surgery and 4 days postoperatively to identify and manage early postoperative IOP spikes. A significant number of patients, particularly those with preexisting glaucoma, had potentially harmful IOP spikes 3 to 7 hours postoperatively.

Publication types

  • Comparative Study

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure
  • Lens Implantation, Intraocular*
  • Ocular Hypertension / diagnosis
  • Ocular Hypertension / drug therapy
  • Phacoemulsification*
  • Postoperative Care / methods*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / drug therapy
  • Retrospective Studies
  • Steroids
  • Time Factors
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / drug therapy
  • Visual Acuity
  • Wound Healing


  • Anti-Inflammatory Agents
  • Antihypertensive Agents
  • Steroids