Changes in Intraocular Pressure After Phacoemulsification: A pilot study in Uganda

Objective: To determine the changes in intraocular pressure after phacoemulsification surgery among patients with cataracts in Southwestern Uganda.Methods: This was a retrospective audit of the Intraocular Pressures (IOP) of patients who underwent a routine clear corneal phacoemulsification surgery for cataracts at Dr. Arunga’s Eye Hospital between December 2020 and December 2023. The IOPs were measured using i-care rebound tonometer at admission, 2 weeks postoperatively, 6 weeks postoperatively, and at discharge from the clinic. Eyes with glaucoma, complicated cataracts, or postoperative complications were not included. The data was analyzed using STATA 17. The mean difference between the admission and discharge IOPs was tested for significance using the Wilcoxon signed-rank test and a relative difference between the mean IOPs at admission and discharge was calculated.Results: A total of 78 eyes from 59 patients were included. The majority of patients, 57.7%, were female. The mean age of the patients was 70.0 years. Best corrected visual acuity of 6/12 or better was achieved in 91% eyes at discharge with a median discharge time of 3 months, and IQR of 2-5 months. The mean intraocular pressures were 14.5 mmHg at admission, 13.3 mmHg at two weeks post-operatively, 12.9 mmHg at 6 weeks, and 11.8 mmHg at discharge. The mean reduction in IOP was 1.6 mmHg between admission and at 6 weeks (p=0.001) and 2.7 mmHg between admission and discharge (p=0.001). IOP reduction 3 months post phacoemulsification showed a 17.9% reduction in IOP compared to baseline. The findings of this study are similar to findings in various studies globally that have reported a decrease in IOP post phacoemulsification.Conclusions: There was a significant reduction in mean intraocular pressure following phacoemulsification. This is the first study assessing changes in intraocular pressure post phacoemulsification in a Ugandan population however the study is limited by a small sample size.