Prophylactic effect of oral acetazolamide against intraocular pressure elevation after cataract surgery in eyes with glaucoma

Session Details

Session Title: Cataract Surgery Paediatric/Complications/Management

Session Date/Time: Monday 09/10/2017 | 16:30-18:00

Paper Time: 17:45

Venue: Room 4.1

First Author: : K.Hayashi JAPAN

Co Author(s): :    M. Yoshida   S. Manabe   K. Yoshimura              

Abstract Details

Purpose:

To confirm the prophylactic effect of oral acetazolamide against increased intraocular pressure (IOP) in the period immediately after cataract surgery in eyes with primary open-angle glaucoma (POAG), and to evaluate the appropriate administration time of oral acetazolamide to prevent IOP elevation.

Setting:

Hayashi Eye Hospital, Fukuoka, Japan

Methods:

Ninety eyes of 90 patients with medically well-controlled POAG scheduled for phacoemulsification surgery were randomly assigned to one of three groups: 1) oral acetazolamide administration (500 mg) at 1 hour preoperatively (preoperative administration group), 2) oral acetazolamide administration (500 mg) at 3 hours postoperatively (postoperative administration group), or 3) no acetazolamide administration (non-administration group). IOP was measured using a rebound tonometer at 1 hour preoperatively; at the conclusion of surgery; and at 1, 3, 5, 7, and 24 hours postoperatively. The incidence of eyes with IOP elevation greater than 100% above the preoperative IOP was examined.

Results:

In all groups, mean IOP was significantly elevated from 3 to 7 hours postoperatively, and then decreased at 24 hours. At 1 and 3 hours, mean IOP was significantly lower in the preoperative administration group than in the postoperative administration or no administration group (P≤0.0031). At 5, 7, and 24 hours, the IOP was significantly lower in both the preoperative and postoperative administration groups than in the non-administration group (P≤0.0224). The incidence of IOP elevation greater than 100% was lower in the preoperative administration group (3.3%) than in the postoperative administration group (23,3%) or non-administration group (26.6%; P=0.0459).

Conclusions:

Eyes with POAG experienced short-term IOP elevation from 3 to 7 hours after phacoemulsification surgery. Oral acetazolamide administration at 1 hour preoperatively significantly reduced the IOP elevation from 1 to 24 hours, while administration at 3 hours postoperatively reduced the IOP elevation at 5 hours or more after surgery.

Financial Disclosure:

NONE