Inuence of Phacoemulsication on Pre-Operative and Post-Operative Intraocular Pressure

. It relies on the area's geographic position, economic situation, cultural diversity, and ethnic integrity. Visual impairment (VI) affects 624 million people worldwide, including 19 million children. Due to decreased productivity, blindness has a major �nancial impact on the individual, family, and society. Objectives: To compare the effect of phacoemulsi ﬁ cation surgery and to determine the mean decrease in pupil size after instilling nepafenac 0.1% (preoperative IOP vs postoperative IOP). Methods: This study was conducted on 120 patients from period 2016-2017, who have given nepafenac 3 drops per day (steroid anti-in�ammatory drops) one dayprior to surgery. The pupil size was measured with acaliper; immediately before (preoperative) and at the end of surgery (postoperative). The difference between pupillary diameters was noted and the decrease in pupil size was calculated. Results: The mean age was 52.53 ± 7.20 years in the given population. There were 42 (35%) males and females were 78 (65%). The preoperative measurement of the pupil size was 7.13 ± 1.06 mm which was reduced to 6.27 ± 1.34 mm at end of surgery. The mean decrease in pupil size was 0.86 ± 0.46 mm. There was signi�cant decrease in pupil size from baseline (preoperative) measurements than after the surgery (p <0.05). Conclusion: It is concluded that nepafenac 0.1% during phacoemulsi ﬁ cation surgery can be bene�cial in maintaining mydriasis in eyes of patients.

version 26.0. The variables analyzed were age, gender and intraocular pressure. The quantitative data like age was presented with simple descriptive statistics like mean and standard deviation. The descriptive data like gender was presented as frequency and percentage. The changes in intraocular pressure and pupil size were presented as mean and standard deviation and paired sample test was performed to compare continuous variable like IOP and pupil size changes in preoperative and postoperative measurements. The comparison for reduction in pupil size with age was analyzed by independent sample t test pvalue ≤0.05 was considered statistically signi cant.

M E T H O D S
minimally invasive, suture-free approach for removing cataracts and implanting IOL [8]. The cornea's endothelium is a layer of cells in the posterior (inner) section of the cornea [9]. Nuclear sclerosis includes malnutrition, low socioeconomic status, and poor education regarding progression [10]. The combination of nuclear sclerosis type of cataract and aging was demonstrated in the Age-Related Eye Disease Study (AREDS) [11]. Studies prove that cases taking vitamin C supplements have advanced situations of eyelid development [12]. In this study researchers compared the effect of phacoemulsi cation surgery to determine the mean decrease in pupil size after i n s t i l l i n g n e p a fe n a c 0 . 1 % ( p r e o p e r a t i ve I O P vs postoperative IOP).
It was aquasi-experimental study conducted on 150 eyes. The patients with cataract between age of 40-65 years were selected for the study. The patients with previous intraocular surgery including YAG iridotomy, ltration surgery, dystrophy, opacity (seen by slit lamp examination), synechial angle closure more than 180 degrees and in ammatory eye disease (seen by slit lamp examination) were excluded from this study. After approval from Ethical Research Board, Services Institute of Medical Sciences/ Services Hospital, total 150 patients ful lling inclusion criteria were enrolled by obtaining the medical record of patients admitted in Eye ward. Written informed c o n s e n t w a s t a k e n f r o m e a c h p a r t i c i p a n t . Sociodemographic information like name, age, and gender were recorded. Preoperative complete ophthalmic examination was performed by measuring intraocular pressure (IOP) with Goldmann Applanation Tonometer. Proper sterile precautions were taken to prepare the area for surgery, including use of antiseptics like povidoneiodine. Sterile drapes, gowns and gloves were employed. A plastic sheet with a receptacle helped to collect the uids during phacoemulsi cation. An eye speculum was inserted to keep the eyelids open. The surgeries were performed by using retro-bulbar anesthesia. An incision with 2.75-mm keratome blade was made on cornea by clearing temporal lobe and the viscoelastic material (USA) was lled in the a n te r i o r c h a m b e r wa s l l e d. T h e n, c o n t i n u o u s phacoemulsi cation using an In niti Vision System (Alcon, USA) was performed consecutively by inserting a foldable intraocular lens (RayOne C ex, Rayner) into the capsular bag. After the viscoelastic material removal, the stromal hydration was used for incision closure. Then, 0.3% Tobramycin eye drops and 0.1% Dexamethasone eye drops were instilled four times a day and gradually decreased over one month after the surgery. The data was entered and analysis was carried out by using the software SPSS

R E S U L T S
A total 150 patients were included in this study. About 30 cases were excluded from the study due to noncompliance and follow-up issues. Baseline characteristics are shown in (  The mean follow-up for pupil size was 7.13 ± 1.06 mm before the surgery and was 6.27 ± 1.34 after the surgery which was statistically signi cant and comparison of decreased pupil size (Mean ± SD 0.952 ± 0.47 in age group of 40-50 and Mean ± SD 0.796 ± 0.44 in age group of 51-65 years) was insigni cantly reduced between two age groups (40-50 and 51-65 years) with p-value 0.064 (Table 2).

Parameters Pupil Size (mm) N=120
Mean±SD  On the other hand, pupil size reduction was insigni cantly associated with gender distribution (p >0.05). The mean preoperative intraocular pressure (IOP) was 18.63 ± 1.80 mmHg and after 24 hours of surgery; the postoperative IOP was 15.21 ± 1.98 mmHg. There was statistically signi cant reduction in IOP after surgery (P 0.000) ( Table 3).

IOP ( mmHg) Score
Preoperative IOP Our study has concluded that intraocular Pressure was reduced after twenty-four hour of surger y than preoperative IOP in patients after phacoemulsi cation. It has been concluded that nepafenac 0.1% during phacoemulsi cation surger y can be bene cial in maintaining mydriasis in eyes of patients. The author(s) received no nancial support for the research, authorship and/or publication of this article