IOP Not Affected by Phacoemulsification in Diabetics

October 22, 2011 (Orlando, Florida) — Phacoemulsification does not affect intraocular pressure (IOP) in patients with diabetes, unlike their nondiabetic counterparts and in contrast to findings from previous studies.

That finding was presented in a scientific poster session here at the American Academy of Ophthalmology 2011 Annual Meeting.

The poster chronicled the results of a retrospective chart review that examined the influence of the ultrasound-induced cataract emulsification technique of phacoemulsification on IOP in both diabetic and nondiabetic patients.

The elevated IOP that can occur in diabetics is a concern because it can be a prelude to deterioration in eye function.

Dr. Lisa Park

This study, conducted by researchers from New York University Langone Medical Center, in New York City, and presented by Lisa Park, MD, examined IOP in 146 eyes of diabetic and nondiabetic patients before and 1 day, 1 week, and 1 month after phacoemulsification of cataracts.

Nondiabetic patients had a significantly lower IOP 1 week (1.7 mm Hg; P = .004) and 1 month (1.8 mm Hg; P = .002) after the phacoemulsification procedure.

However, IOP was not significantly altered in diabetic patients 1 week (0.4 mm Hg; P = .4) or 1 month (0.1 mm Hg; P = .9) after the procedure.

IOP differed significantly between nondiabetics and diabetics at 1 week (12.7 vs 15.2 mm Hg; P = .0001) and 1 month (12.6 vs 15.5 mm Hg; P = .0002).

"Our results show that postoperative IOP is significantly different between diabetic and nondiabetic patients, and that the pressure-lowering effect [seen in previous studies] is not demonstrable in the diabetic population," conclude the researchers.

These findings might reflect a lack of concerted research in this area. "Not a lot has been known about postoperative IOP in diabetics. Information has been more anecdotal. A number of factors can be involved in IOP. Our study is different, in that we focused exclusively on IOP and diabetes," Dr. Park told Medscape Medical News.

If these findings bear out, they might indicate that cataract surgery in some diabetic patients does not carry the benefit of lowered IOP, which could herald longer-term eye problems beyond cataract resolution.

"With the population aging and diabetes growing to epidemic proportions, we are going to need to focus more on this segment of the population. Management to reduce IOP after surgery along with management of inflammatory reactions could be done," said Dr. Park.

The authors have disclosed no relevant financial relationships.

American Academy of Ophthalmology (AAO) 2011 Annual Meeting: Scientific poster 4. Presented October 23, 2011.