[Factors influencing intraocular pressure elevation on the first postoperative day following small-incision cataract surgery--the effect of apraclonidine].

PURPOSE: To investigate the effects of apraclonidine on intraocular pressure elevation after cataract surgery and the factors associated with elevated intraocular pressure. METHODS: A group of patients (apraclonidine group) was administered a drop of apraclonidine before and one drop after surgery, and the difference between the intraocular pressure in the apraclonidine group and the non-use group was investigated postoperatively. On the first postoperative day, multivariate analysis was performed using intraocular pressure as the objective value and other variable factors involved in the surgery as the explanatory variables. RESULTS: On the first postoperative day, the intraocular pressure in the apraclonidine group (520 eyes: 15.5 +/- 4.9 mmHg) was significantly lower than that in the non-use group (577 eyes: 18.7 +/- 7.2 mmHg) (p < 0.001). The significant variables included preoperative intraocular pressure, apraclonidine use, sex (men > women), poor mydriasis, acetylcholine use, pseudoexfoliation, and diabetes mellitus. CONCLUSIONS: Apraclonidine is useful in suppressing postoperative elevation of intraocular pressure.

Cumulative probability of neodymium: YAG laser posterior capsulotomy after phacoemulsification.

PURPOSE: To retrospectively analyze the cumulative probability of neodymium:YAG (Nd:YAG) laser posterior capsulotomy after phacoemulsification and to evaluate the risk factors. SETTING: Ando Eye Clinic, Kanagawa, Japan. METHODS: In 3997 eyes that had phacoemulsification with an intact continuous curvilinear capsulorhexis, the cumulative probability of posterior capsulotomy was computed by Kaplan-Meier survival analysis and risk factors were analyzed using the Cox proportional hazards regression model. The variables tested were sex; age; type of cataract; preoperative best corrected visual acuity (BCVA); presence of diabetes mellitus, diabetic retinopathy, or retinitis pigmentosa; type of intraocular lens (IOL); and the year the operation was performed. The IOLs were categorized as 3-piece poly(methyl methacrylate) (PMMA), 1-piece PMMA, 3-piece silicone, and acrylic foldable. RESULTS: The cumulative probability of capsulotomy after cataract surgery was 1.95%, 18.50%, and 32.70% at 1, 3, and 5 years, respectively. Positive risk factors included a better preoperative BCVA (P =.0005; risk ratio [RR], 1.7; 95% confidence interval [CI], 1.3-2.5) and the presence of retinitis pigmentosa (P<.0001; RR, 6.6; 95% CI, 3.7-11.6). Women had a significantly greater probability of Nd:YAG laser posterior capsulotomy (P =.016; RR, 1.4; 95% CI, 1.1-1.8). The type of IOL was significantly related to the probability of Nd:YAG laser capsulotomy, with the foldable acrylic IOL having a significantly lower probability of capsulotomy. The 1-piece PMMA IOL had a significantly higher risk than 3-piece PMMA and 3-piece silicone IOLs. CONCLUSIONS: The probability of Nd:YAG laser capsulotomy was higher in women, in eyes with a better preoperative BCVA, and in patients with retinitis pigmentosa. The foldable acrylic IOL had a significantly lower probability of capsulotomy.