14585
document
Prevention of acute postoperative pressure rises in glaucoma patients undergoing cataract extraction with posterior chamber lens implant . Acute elevations in intraocular pressure ( IOP ) commonly follow extracapsular cataract extraction and lens implant in glaucoma patients . Thirty six patients with glaucoma undergoing cataract extraction and posterior chamber lens implantation received one of three treatments . Group 1 : 500 mg of Diamox Sustets ( acetazolamide ) 1 hour preoperatively ( 10 patients ) ; Group 2 : peroperative intracameral Miochol ( acetylcholine ) ( 11 patients ) ; Group 3 : the above treatments combined ( 15 patients ) . IOPs were measured at 3 , 6 , 9 , and 24 hours postoperatively . The average of the maximum pressure rises above the preoperative level over the 24 hour period was greatest for the group receiving acetazolamide only at 8.9 mm Hg ; for the acetylcholine group the average maximum rise was 6.3 mm Hg ; while the combined treatment group showed a decrease of 0.7 mm Hg . IOP rises of > 6 mm Hg were seen in 7 % of patients ( one of 15 ) in the combined treatment group , 45 % ( five of 11 ) of the acetylcholine group , and 70 % ( seven of 10 ) of the acetazolamide group . IOP rises of > 10 mm Hg were seen in 7 % of the combined treatment group , in 18 % of the acetylcholine only group , and in 50 % of the acetazolamide only group . A pressure rise > 20 mm Hg was seen in one patient receiving acetazolamide only and one patient receiving acetylcholine only . The difference between the acetylcholine group and the combined group for rises > 6 mm Hg was significant using the chi 2 test while the acetazolamide group showed a significant difference for rises > 6 and 10 mm Hg compared with the combined group . All acute pressure rises were recorded before or at 9 hours following operation except in the combined treatment patient where the rise occurred at 24 hours . To prevent the acute IOP rises seen following cataract surgery with lens implant in glaucoma patients we recommend combined ocular hypotensive therapy .
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Intervention_Pharmacological
Diamox Sustets ( acetazolamide )
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Intervention_Pharmacological
peroperative intracameral Miochol ( acetylcholine )
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Intervention_Control
treatments combined
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Intervention_Pharmacological
acetazolamide
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Intervention_Pharmacological
acetylcholine
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Intervention_Pharmacological
acetylcholine
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Intervention_Pharmacological
acetazolamide
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Intervention_Pharmacological
acetylcholine
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Intervention_Pharmacological
acetazolamide
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Intervention_Pharmacological
acetazolamide
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Intervention_Pharmacological
acetylcholine
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Intervention_Pharmacological
acetylcholine
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Intervention_Pharmacological
acetazolamide
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Intervention_Pharmacological
combined treatment
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Outcome_Physical
intraocular pressure ( IOP )
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Outcome_Physical
IOPs
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Outcome_Physical
average of the maximum pressure rises
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Outcome_Physical
IOP rises
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Outcome_Physical
IOP rises
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Outcome_Physical
pressure rise > 20 mm Hg
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Outcome_Physical
rises > 6 mm Hg
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Outcome_Physical
rises > 6
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Outcome_Physical
acute pressure rises
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Outcome_Physical
acute IOP
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Participant_Condition
glaucoma
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Participant_Condition
posterior chamber lens implant
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Participant_Sample-size
Thirty six