If your highly myopic patient recently had cataract surgery, keep an eye out for early, transient intraocular pressure (IOP) spikes, a team of Chinese researchers suggest. Their study, published in the British Journal of Ophthalmology, found high myopes were predisposed to these early pressure spikes post-cataract surgery and especially if they were male, had longer axial length, shallower anterior chamber depth and greater beta-zone peripapillary atrophy.

The study recruited patients who were treated with phacoemulsification for cataract removal, and the participants’ IOP was measured prior to surgery and again one day, three days, one week and three months after the procedure. One week after surgery, investigators also measured the patients’ axial length and anterior chamber depth and used fundus photography to image the optic disc tilt, rotation and beta-zone peripapillary atrophy.

The study included 94 eyes of highly myopic cataract patients, and the control group consisted of 67 eyes with age-related cataract. One day after surgery, the investigators saw a higher early IOP spike in the high myope group compared with the age-related cataract group (28% vs. 10%, respectively). The high myopes who had IOP spikes tended to be male, and their affected eyes showed longer axial length, shallower anterior chamber depth, greater optic disc tilt and larger beta-zone peripapillary atrophy.

Zhu X, Qi J, He W, et al. Early transient intraocular pressure spike after cataract surgery in highly myopic cataract eyes and associated risk factors. Br J Ophthalmol. November 8, 2019. [Epub ahead of print].