Positional Intraocular Pressure between Phakic and Pseudophakic Eyes after Cataract Surgery in a Single Eye

Ko Un Shin; Jae Yeun Lee; Yu Sam Won; Joon Mo Kim

doi:10.3341/jkos.2017.58.2.185

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Shin, Lee, Won, and Kim: Positional Intraocular Pressure between Phakic and Pseudophakic Eyes after Cataract Surgery in a Single Eye

Original Article

J Korean Ophthalmol Soc 2017;58(2):185-191.

Published online: 8 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.2.185

Positional Intraocular Pressure between Phakic and Pseudophakic Eyes after Cataract Surgery in a Single Eye

Ko Un Shin, M.D., Jae Yeun Lee, M.D., Yu Sam Won, M.D., Joon Mo Kim, M.D., PhD

Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

Address reprint requests to Joon Mo Kim, MD, PhD Department of Ophthalmology, Kangbuk Samsung Hospital,#29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea Tel: 82-2-2001-2250, Fax: 82-2-2001-2262 E-mail: kjoonmo1@gmail.com

Received 1 September 20167 December 2016 Accepted 17 January 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

In the present study, the dependence of intraocular pressure (IOP) on body position was compared between pseudo-phakic and phakic eyes after cataract surgery performed at least 3 months prior.

Methods

IOP was measured in 214 patients over 40 years of age who received cataract surgery at least 3 months prior. The present study included 104 patients who did not have any other ocular disease which could influence visual acuity or IOP. The IOP was measured in 4 different positions, sitting, supine, right decubitus, and left decubitus by a single skilled researcher using Icare tonometer. In addition, IOP was compared between the phakic and pseudophakic eyes, specifically, the dependent eye in the decubitus position.

Results

The comparison between the phakic and pseudophakic eyes in patients after cataract surgery in a single eye showed IOP was not different between the sitting and supine positions; however, in the decubitus position, IOP in the dependent eye was significantly higher than the non-dependent eye ( p = 0.001). Additionally, regardless of lens status, IOP was significantly higher in the dependent eye than non-dependent eye.

Conclusions

Both body position and lens status can affect IOP. After cataract surgery, regardless of lens status, IOP was higher in the dependent eye than non-dependent eye of patients in the decubitus position.

Keywords: Cataract surgery, Glaucoma, Intraocular pressure, Positional intraocular pressure

References

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Table 1.

Patients demographics

	Cataract surgery
	Right eye	Left eye	Both eye
Gender (n, %)
Men	20 (63)	18 (53)	16 (42)
Women	12 (37)	16 (47)	22 (58)
Age (years)	64.0 ± 13.8	69.7 ± 11.4	73.5 ± 8.2
Systemic disease (n, %)
DM	9 (28)	5 (15)	7 (18)
HTN	12 (38)	11 (32)	19 (50)

Values are presented as mean ± SD or n (%). DM = diabetes mellitus; HTN = hypertension.

Table 2.

Positional IOP of patients underwent cataract surgery on single eye

Cataract surgery	IOP measured eye	Position
Cataract surgery	IOP measured eye	Sitting (mmHg)	Supine (mmHg)	RD (mmHg)	LD (mmHg)
Right eye	Right eye	12.94 ± 3.80	15.13 ± 4.50	18.39 ± 3.01	16.71 ± 2.32
	Left eye	13.42 ± 3.95	15.50 ± 4.38	16.45 ± 2.23	18.52 ± 2.83
	p-value^*	0.575	0.730	0.005	0.007
Left eye	Right eye	13.83 ± 2.78	17.42 ± 2.64	19.30 ± 2.66	16.95 ± 2.99
	Left eye	12.97 ± 2.56	16.46 ± 2.57	16.47 ± 2.66	18.53 ± 2.26
	p-value^*	0.206	0.151	<0.001	0.022

Values are presented as mean ± SD unless otherwise indicated.

IOP = intraocular pressure; RD = right decubitus; LD = left decubitus.

^* Analyzed with paired T-test.

Table 3.

IOP with decubitus position

Cataract surgery	IOP measured eye	Position		p-value^*
Cataract surgery	IOP measured eye	RD (mmHg)	LD (mmHg)	p-value^*
Right eye	Right eye	18.39 ± 3.01	16.71 ± 2.32	0.001
	Left eye	16.45 ± 2.23	18.52 ± 2.83	<0.001
Left eye	Right eye	19.30 ± 2.66	16.95 ± 2.99	0.001
	Left eye	16.47 ± 2.66	18.53 ± 2.26	0.072

Values are presented as mean ± SD unless otherwise indicated.

IOP = intraocular pressure; RD = right decubitus; LD = left decubitus.

^* Analyzed with paired T-test.

Table 4.

Positional IOP of dependent eye and non-dependent eye

Cataract surgery	Position	IOP (mmHg)	p-value^*	p-value^†
Right eye	RD Right eye	18.39 ± 3.01	0.862	0.861
	LD Left eye	18.52 ± 2.83
	LD Right eye	16.71 ± 2.32	0.650	0.650
	RD Left eye	16.45 ± 2.23
Left eye	LD Left eye	18.53 ± 2.26	0.961	0.960
	RD Right eye	19.30 ± 2.66
	RD Left eye	16.47 ± 2.66	0.509	0.500
	LD Right eye	16.95 ± 2.99

Values are presented as mean ± SD unless otherwise indicated.

IOP = intraocular pressure; RD = right decubitus; LD = left decubitus.

^* Analyzed with paired T-test

^† Analyzed with ANCOVA adjust for age.

Table 5.

Comparing positional IOP between right cataract surgery and left cataract surgery

		Right cataract surgery (mmHg)	Left cataract surgery (mmHg)	p-value^*
Sitting	Right eye	12.94 ± 3.80	13.98 ± 2.78	0.168
	Left eye	13.42 ± 3.95	12.97 ± 2.56	0.961
Supine	Right eye	15.13 ± 4.50	17.42 ± 2.64	0.062
	Left eye	15.50 ± 4.38	16.46 ± 2.57	0.174
RD	Right eye	18.39 ± 3.01	19.30 ± 2.66	0.063
	Left eye	16.45 ± 2.23	16.47 ± 2.66	0.084
LD	Right eye	16.71 ± 2.32	16.95 ± 2.99	0.611
	Left eye	18.52 ± 2.83	18.53 ± 2.26	0.068

Values are presented as mean ± SD unless otherwise indicated.

IOP = intraocular pressure; RD = right decubitus; LD = left decubitus.

^* Analyzed with paired T-test.

Table 6.

Comparing IOP in dependent position between pseu-dophakia and phakic eye

	Position (IOP measured eye)	IOP (mmHg)	p-value^*	p-value^†
Pseudophakia	RD (right eye)	18.39 ± 3.01	0.174	0.220
	LD (left eye)	18.53 ± 2.26
Phakic eye	RD (right eye)	19.30 ± 2.66	0.154	0.367
	LD (left eye)	18.52 ± 2.83

Values are presented as mean ± SD unless otherwise indicated. IOP = intraocular pressure; RD = right decubitus; LD = left decubitus.

^* Analyzed with paired T-test

^† Analyzed with analysis of covariance (ANCOVA) adjust for age.

Table 7.

Comparing positional IOP after cataract surgery on both eyes

		IOP (mmHg)	p-value^*
Sitting	Right eye	13.33 ± 3.10	0.825
	Left eye	13.48 ± 3.01
Supine	Right eye	16.33 ± 2.70	0.670
	Left eye	16.07 ± 2.61
RD	Right eye	17.81 ± 2.31	0.103
	Left eye	16.92 ± 2.40
LD	Right eye	17.07 ± 2.56	0.364
	Left eye	17.57 ± 2.17

Values are presented as mean ± SD unless otherwise indicated.

IOP = intraocular pressure; RD = right decubitus; LD = left decubitus.

^* Analyzed with paired T-test.

Table 8.

Positional IOP in phakic eye and pseudophakia

	Sitting (mmHg)	Supine (mmHg)	RD (mmHg)	LD (mmHg)
Phakic eye	13.31 ± 3.16	16.01 ± 3.61	17.37 ± 2.55	17.61 ± 2.81
Pseudophakia	12.91 ± 2.96	15.56 ± 3.47	16.93 ± 2.99	16.81 ± 2.31
p-value^*	0.456	0.462	0.249	0.079

Values are presented as mean ± SD unless otherwise indicated.

IOP = intraocular pressure; RD= right decubitus; LD = left decubitus.

^* Analyzed with paired T-test.

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