During the immediate postoperative period following cataract surgery, the intraocular pressure (IOP) often rises significantly to impede the ocular circulation and threaten the visual function of the optic disc in some patients with vulnerable
ocular
disease such as advanced glaucomas. Some kind of ocular hypotensives, acetazolamide and beta-adrenergic blockers were reported to be effective for preventing or aborting the immediate postoperative IOP rise. Other ocular hypotensives, pilocarpine
and
carbachol are used for the purpose of constricting the pupil at the end of cataract surgery. However, they were not evaluated to prevent the postoperative IOP rise after uneventful extracapsular cataract extraction and posterior chamber lens
implantation. Fifty-three eyes wee randomly assigned to the three group: group 1 as a control group consisting of 24 eyes in which no ocular hypotensives were administered; group 2 consisting of 16 eyes in which pilocarpine 4% was instillated at
the end
of surgery ; group 3 of 14 eyes in which 0.1ml of carbachol 0.01% was infused into the anterior chamber at the end of the surgery. A slit-lamp examination and applanation tonometry were done at 6 hours, day 1, 2, 3, week 1, 2, the first and
second
month
after operation. Preoperative baseline IOP means were not different between three groups(P>0.05). An average postoperative 6-hour mean IOP were lower than those baseline IOP in group 2 and 3 by 1.8±3.36mmHg and 0.6±4m3mmHg respectively although
these
were not statistically significant(P<0.05). Mean IOPs measured at other postoperative periods were not different between three groups and did not increased comparing with the baseline mean IOP(P>0.05). Therfore a single administration of
pilocarpine 4%
or carbachol 0.01% was found to be effective to prevent the immediate postoperative IOP rise.
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