Posters

Case series: aqueous release to treat intraocular pressure spikes post-cataract surgery

Poster Details

First Author: R.Nitiahpapand UK

Co Author(s): C. Gizzi   A. Sharma                 

Abstract Details

Purpose:

Intraocular (IOP) rise after cataract surgery is an important and common problem. IOP can adversely affect vision and can be particularly detrimental in glaucoma patients with pre-existing visual field defects. The aim of this case series is to evaluate the efficacy and safety of aqueous humour release (also known as ‘burping’ of the wound) – a procedure that has been used for decades but has no published evidence and has uncertainty regarding amount and duration of IOP decrease and related complications.

Setting:

Moorfields Eye Unit at Bedford Hospital, Bedford, UK

Methods:

9 patients with an IOP greater than 30mmHg or deemed inappropriate in view of the ocular condition (e.g. glaucoma) were recruited. These patients underwent ‘burping’ of the wound and had their IOP measured immediately and 1-2 hours after the procedure. The ‘burping’ pressure was repeated until satisfactory pressure was noted and no noticeable shallowing of the anterior chamber was observed. A Siedel test with fluorescein 2% was used to test for leaks and patients were given a drop of chloramphenicol 0.5% to prevent any infections. Patients then continued with their regular post-operative care.

Results:

9 eyes (7 right, 2 left) of 9 patients had an average IOP spike of 32mmHg (range 30-52mmHg) had aqueous release without any complications. Immediately after the pressure reduced to an average of 8mmHg (range 2-16mmHg). 6 patients required a second attempt, 1 required a third, and 1 patient required a fourth attempt. IOP check the following day was within normal limits for all the patients.

Conclusions:

This case series shows that IOP spikes post-cataract surgery can be significant and aqueous release of the wound has a role in managing these acute spikes immediately to prevent loss of vision and improve patient outcomes.

Financial Disclosure:

None