Risk factors for intraocular pressure elevation during the early period post cataract surgery

Purpose To assess the risk factors for intraocular pressure (IOP) elevation during the early period post cataract surgery. Study design Retrospective study. Methods This study involved 1587 eyes that underwent cataract surgery at the Baptist Eye Institute, Kyoto, Japan between April 2020 and May 2021. In all subjects, risk factors for early postoperative IOP elevation (i.e., an increase of IOP of 10 mmHg or more at 1-day postoperative compared with that at baseline, or a postoperative IOP of 28 mmHg or more) were analyzed by multivariate logistic regression analysis. Results Of the 1587 treated eyes in this study, 100 (6.3%) experienced early-postoperative IOP elevation. Of those 100 eyes, 78.0% were men, 27.0% had an axial length (AL) of ≥ 26.5 mm, 23.0% had a history of glaucoma treatment, 11.0% had poor mydriasis and 10.0% had intraoperative floppy iris syndrome (IFIS). Multivariate analysis findings revealed that male [odds ratio (OR) 4.36; 95% confidence interval (CI) 2.63–7.23; P < 0.001], AL of ≥ 26.5 mm (3.11; 1.83–5.30; P < 0.001), a history of glaucoma treatment (2.83; 1.63–4.91; P < 0.001), poorly mydriasis (2.63; 1.16–6.01; P = 0.02), IFIS (4.37; 1.78–10.74; P = 0.001) and baseline high IOP (1.09; 1.01–1.18; P = 0.03) were associated with increased IOP during the early period post cataract surgery. Conclusions The findings in this study reveal that male sex, high myopia, a history of glaucoma treatment, poor mydriasis, IFIS and baseline high IOP are risk factors for IOP elevation during the early period post cataract surgery.