Study of the Effects of Various Intraocular Pressure Reducing Drugs in Reducing Postoperative Rise in Intraocular Pressure after Cataract Surgery

Methods : This post operative randomized double masked clinical trial comprised patients with age related cataract having undergone extracellular cataract extraction (ECCE) with or without posterior chamber Intra ocular lense implementation (PC-IOL). They were randomly assigned to use topical timoilol or betaxolol or levobunalol or acetazolamide or intracameral pilocarpine (Group 1a/1b/1c/1d/.1e) respectively at the completion of the surgery. Two controls were taken- a . Intra-ocular pressure in the follow eye (Control-I) b . Intraocular pressure in the operated eye ,in which no Introcular pressure reducing drugs had been instilled (Control-II ) (Group-II). Intraocular pressure (IOP) was measured 6 hours, 24hours, 3 rd day, 7 th day and 2 nd month postoperatively. The anterior chamber was examined for the levels of cells and flare using slit lamp examination. Results : Levobunalol was more effective in reducing post operative IOP rise at 6 hours of surgery, 3 rd day, 7 th day 1 st month, and 2 nd month where as Timolol was more effective at 24 hours. There were significant difference in IOP between Group-I (those patients who received topical iop reducing drugs) and group-II (operated patients without any IOP reducing drugs) post operatively (p<0.05). No excessive postoperative inflammation was observed in any group. In the control group-I (fellow eye), IOP remained constant throughout the period. This indicated that the drugs were not playing any major role in altering IOP of the fellow eye. In the control II (group-II), maximum mean pressure rise was 18 mm Hg at six hours. This indicated that it was the operative procedure that was causing the rise in IOP. Diurnal variation in IOP was playing no significant role.