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Early transient intraocular pressure spike after cataract surgery in highly myopic cataract eyes and associated risk factors
  1. Xiangjia Zhu1,2,3,4,
  2. Jiao Qi1,2,3,4,
  3. Wenwen He1,2,3,4,
  4. Shaohua Zhang1,2,3,4,
  5. Keke Zhang1,2,3,4,
  6. Qiang Lu1,2,3,4,
  7. Yi Lu1,2,3,4
  1. 1 Department of Ophthalmology, the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, People’s Republic of China
  2. 2 NHC Key Laboratory of Myopia (Fudan University), Shanghai, People’s Republic of China
  3. 3 Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, People’s Republic of China
  4. 4 Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People’s Republic of China
  1. Correspondence to Dr Yi Lu, Department of Ophthalmology, the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, People’s Republic of China; luyieent{at}


Purpose To investigate the incidence of the early transient intraocular pressure (IOP) spike after cataract surgery in eyes with highly myopic cataract (HMC) and associated risk factors.

Methods Consecutive patients treated with phacoemulsification were recruited. IOP was measured before and 1 day, 3 days, 1 week and 3 months after surgery. Axial length (AL) and anterior chamber depth (ACD) were recorded, and optic disc tilt, rotation and beta-zone peripapillary atrophy (β-PPA) were measured from fundus photographs taken 1 week after surgery. Backward stepwise multiple linear regression was used to investigate the risk factors for early transient IOP spike in the HMC group.

Results Finally, 94 eyes of 94 HMC patients and 67 eyes of 67 age-related cataract (ARC) controls were included in analysis. The incidence of early IOP spike was 10% in the ARC group and 28% in the HMC group (OR=3.277, p<0.05) at 1 day after surgery. In the HMC group with IOP spikes, more males were seen and affected eyes showed longer AL, shallower ACD, greater optic disc tilt, and larger β-PPA than those without (all p<0.05). Multivariate analysis showed that sex, AL, ACD, and area of β-PPA were significantly associated with an early transient IOP spike in HMC eyes (all p<0.05).

Conclusions Highly myopic eyes are more susceptible to early transient IOP spike after cataract surgery, and male sex, longer AL, shallower ACD, and greater β-PPA are associated risk factors.

Clinical trial registration number NCT02182921.

  • intraocular pressure

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  • XZ, JQ and WH contributed equally.

  • Correction notice This article has been corrected since it was published Online First. Minor formatting has been corrected.

  • Contributors XZ designed the study. JQ, WH, SZ, KZ and QL performed the study. JQ and SZ performed data collection and management. WH, KZ and QL performed data analysis and interpretation. XZ and YL wrote and reviewed the manuscript. All authors have approved the manuscript.

  • Funding This work was supported by the National Natural Science Foundation of the People’s Republic of China (grant numbers 81870642, 81970780, 81470613, and 81670835), the Shanghai High Myopia Study Group, the Shanghai Talent Development Fund (grant number 201604), the Outstanding Youth Medical Talents Program of Shanghai Health and Family Planning Commission (grant number 2017YQ011) and the National Key R&D Program of China (grant number 2018YFC0116800).

  • Competing interests None declared.

  • Ethics approval This prospective cohort study was approved by the Institutional Review Board of the Eye and Ear, Nose, and Throat Hospital of Fudan University. All procedures adhered to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request.