Post-cataract patients who experienced an elevated IOP in their first eye were 23.9% more likely to experience an IOP spike in their second eye. The authors of this paper presented at ARVO 2024 say physicians should consider this risk in patient care strategies.

Post-cataract patients who experienced an elevated IOP in their first eye were 23.9% more likely to experience an IOP spike in their second eye. The authors of this paper presented at ARVO 2024 say physicians should consider this risk in patient care strategies. Photo: Christina Tran, BS, and Leonid Skorin, Jr., DO, OD. Click image to enlarge.

Research has established several contributing factors to elevated intraocular pressure (IOP) after cataract surgery, including male gender, high myopia, longer axial length, shallow anterior chamber depth, history of glaucoma treatment and high baseline IOP. However, a study presented last week at ARVO explored the connection between an IOP spike in the first eye and its potential role in predicting an IOP spike in the second eye.

The retrospective cohort study included 5,226 cataract patients in the University of Colorado Cataract Outcomes Database. IOP spike was defined as a post-surgery day one IOP >30mm Hg or IOP >10mm Hg change from baseline. Researchers used multivariable logistic regression to assess the primary association with adjustment for potential confounding variables. They found the overall incidence of IOP spikes in the second eye was 4.6%, and 4.5% in the first eye. Patients who had an IOP spike in the first eye had a 23.9% incidence of an IOP spike in the second eye. The incidence rate was only 3.8% for patients who didn’t have an IOP spike in their first eye.

The authors concluded that a first-eye IOP spike has a profound influence on a second-eye IOP spike, regardless of other established preoperative and intraoperative risk factors. They recommend that physicians recognize and address this risk when managing patient care.

Original abstract content ©2024 Association for Research in Vision and Ophthalmology.

Gnanaraj R, Taravella M, Lynch A, Patnaik J. First eye intraocular pressure spike as predictor of second eye spike in cataract surgery. ARVO 2024 annual meeting.