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Early postoperative intraocular pressure elevation following cataract surgery

Grzybowski, Andrzeja,b; Kanclerz, Piotrc

Current Opinion in Ophthalmology: January 2019 - Volume 30 - Issue 1 - p 56–62
doi: 10.1097/ICU.0000000000000545

Purpose of review The aim of this review was to assess the risk factors and course of postoperative intraocular pressure (IOP) increase in order to determine the optimal the treatment.

Recent findings Early postoperative IOP elevation following cataract surgery is a frequent adverse event, and might represent 88% early postoperative complications. The risk factors for IOP elevation following phacoemulsification cataract surgery include residual viscoelastic material, resident performed surgery, glaucoma, pseudoexfoliation syndrome, axial length over 25 mm, tamsulosin intake, topical steroid application in steroid responders. A day-1 postoperative follow-up might be questioned, even in glaucoma patients, as in IOP spikes the topmost IOP elevation occurs 3–4 h postoperatively.

Summary Several IOP-lowering agents have been evaluated, but none has completely prevented the occurrence of IOP spikes. We recommend applying a combination of dorzolamide/timolol and brinzolamide topically in high-risk patients, particularly with preexisting optic nerve damage. Corticosteroid cessation usually results in a reduction of the IOP to normal levels in steroid responders. Additional studies are required to assess the optimal treatment, especially in glaucoma patients.

aDepartment of Ophthalmology, University of Warmia and Mazury, Olsztyn

bInstitute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan

cPrivate Practice, Gdańsk, Poland

Correspondence to Andrzej Grzybowski, MD, PhD, MBA, Professor of Ophthalmology, Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, 60-554 Gorczyczewskiego 2/3, Poznan, Poland. Tel: +48 503 036 136; e-mail:

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