Eye Pressure after Cataract Surgery

Dear Doctor,

My wife ( 50 years of age) underwent Cataract Surgery on the 9th April 2011.

Procedure done: Micro Incision Cataract Surgery with Foldable Intra Ocular Lens Implantation Done on the Left Eye.

Discharge Summry says:

General Disease :           Nil

General COndition : All Under COntrol

General Examination:

B.P  110/80 mmhg

C V S  : N A D
RS      : N A D

Opthalmic Examination

REV  : 6/12 P     LEV  : 6/12 P
RE:  Cataract
LE : Cataract

Investigations

Topography report  : Flat "K" :  43.25 D          Steep "K"  : 44.50 D

A-Scan Report  : 24 mm

Post Operatice Note:

AC Well formed

On Dischanrge : Eye Quiet

Advised Follow up and Medicines:

1) Presnisolone Acetate Opthalmic Suspension USP1

2) Zymar Eye Drops

3) Megabrom Eye Drops

After a week she was asked to meet with the Doctor for follow up and Eye pressure test was done.

The Eye pressure was 22.  The Doctor said Eye nerves are fantastic but the pressue is more than the range( 20) He also said it may be due to application of Presnisolone Acetate Opthalmic Suspension USP1.  

He has asked her to continue drops excetp Zymar and asked her to replace it with Refresh Liquigel

Please let me know what causes the higer eye pressure and what is the remedy.


My observation was that when the eye pressure test was done the patient was not told/informed that AIR will be blown on the eye for the test. When air was blown my wife felt little uncomfortable at that time.

Please let me have your expert opinion.

thanks and best regards

A.Mohamed Ali
Chennai,
India
e-mail: ***@****

[John C Hagan III, MD, FACS, FAAO]

Increased IOP after cataract surgery is common. 22 is not that high and likely will not require any treatment. Follow your surgeon's advice.

JCH MD

[ledbrv]

vamali,

A Dr. here at medhelp of course will a have a more precise and correct information than my, but as far as know, as your doctor said, Prednisolone Acetate Opthalmic Suspension USP1 could increase IOP. I had a cataracat surgery 2 months ago and use the same drops. In my case IOP 12 hours after surgery was 24, but 5 days after it was already at 17, but, as I use glaucoma drops, they helped  keep my IOP below 20. You wife IOP should go back to normal when she stops use the drops, which should not take too long. In my case I used Prednisolone for 28 days. Confirm with your doctor, but I think a month is not enough time to cause harm.

[vamali]

Dear Doctor John C Hagan III, MD, FACS  ,

Thanks a lot for your expert opinion.

Best regards
A.Mohamed Ali
Chennai,
India

[cwatt1]

I agree with ledbrv -- it sounds like your wife is doing fine.  The fact that your her eye surgeon took her off the Zymar is pretty standard, too -- generally antibiotics are started a day or two before cataract surgery and are continued for a brief period of time afterward.

As Dr. Hagan stated, a termporary increase in IOP after cataract surgery is common.  If her surgeon were considered about her IOP, he would have stopped the prednisolone.

[vamali]

Dear Doctor John C Hagan III, MD, FACS  ,


As I mentioned earlier my wife underwent cataract surgery on the 9th April 2011

Procedure done: Micro Incision Cataract Surgery with Foldable Intra Ocular Lens Implantation Done on the Left Eye.

Yesterday the 3rd May We went to the same hospital and had the second review with the doctor.  Even yesterday , after 23 days of surgery, the IOP was 24 on both eyes( She is still on , Prednisolone Acetate Opthalmic Suspension USP1 , TWICE a day this week and once a day next week.

The hospital suggested to have a Glucoma test.  Her vison is perfect and the same doctors during all the consulatations confirmed that the neves are in perfect order and no problems at all.  Her visiion is extremely good on the left eye for which the surgery was done. She has cataract in the right eye too.  The IOP on both eyes readin 24 is my concern.  Please educate me and help me with your expert opinion.

Here in my country most of the hospitals, on knowing that the insurance company pays the bill for treatment, will suggest so many tests.

When I asked the doctor who suggested Glucoma test, he said that he wants to rule out the possibility og Glucoma and hence asked for the test.  Is is necessary to under go this test.

I shall be thankful for your opinion and suggestions

Thanks and best regards
A.Mohamed Ali
Chennai India