Optimal Timing for Intraocular Pressure Measurement Following Phacoemulsification Cataract Surgery: A Systematic Review and a Meta-Analysis.

Abstract

Post-operative increases in intraocular pressure (IOP) are a frequent complication following phacoemulsification cataract surgery. Assessment of IOP is an essential element in post-operative checks. Despite this, guidance regarding the optimal timing remains vague. The purpose of this meta-analysis was to determine the current status of evidence that may help guide best practice regarding the optimal time following phacoemulsification cataract surgery to measure IOP. A comprehensive literature search was performed on MEDLINE and EMBASE. In two stages, independent reviewers screened articles that reported IOP measurements following uncomplicated cataract surgery. Risk of Bias Assessment was conducted following data extraction. The meta-analysis incorporated 57 randomized clinical studies involving a total of 6318 participants and 7089 eyes. Post-operative hour one had a significant decrease in IOP from baseline, while hour two had a non-significant increase. Post-operative hours four, six, and eight were the only timepoints to have a significant increase in IOP. Finally, post-operative day one had no significant change in IOP, while day two had a non-significant decrease. These results suggest that the optimal time to measure IOP is within the first 4-8 h following phacoemulsification cataract extraction. Taking measurements too soon or too late could result in missed IOP spikes.