Purpose: To investigate the natural course of intraocular pressure (IOP) after small-incision cataract surgery with sodium hyaluronate 1% versus hydroxypropylmethylcellulose 2%.
Design: Randomized clinical trial.
Participants: Eighty eyes of 40 consecutive patients with bilateral age-related cataract.
Methods: The patients were assigned randomly to receive sodium hyaluronate 1% or hydroxypropylmethylcellulose 2% during cataract surgery in the first eye. The second eye received the other ophthalmic viscosurgical device. The IOP was measured preoperatively and 30 minutes; 1, 2, 3, 4, 6, 8, and 20 to 24 hours; and 1 week postoperatively.
Main outcome measure: Postoperative IOP increase.
Results: The highest mean IOP increase occurred at 8 hours postoperatively (5.3+/-6.4 mmHg) in the sodium hyaluronate 1% group and at 2 hours postoperatively (7.8+/-6.1 mmHg) in the hydroxypropylmethylcellulose 2% group. Overall, the IOP increase was higher with hydroxypropylmethylcellulose 2% (P = 0.005). Intraocular pressure spikes to > or =30 mmHg occurred in 5 eyes (13%) in the sodium hyaluronate 1% group and 13 eyes (33%) in the hydroxypropylmethylcellulose 2% group.
Conclusions: Sodium hyaluronate 1% and hydroxypropylmethylcellulose 2% caused significant IOP increases during the first 8 hours after cataract surgery. A single measurement at 6 hours postoperatively could detect all IOP spikes in the sodium hyaluronate 1% group. In the hydroxypropylmethylcellulose 2% group, a single measurement at 2 hours postoperatively could detect two thirds of IOP spikes.