Raised intraocular pressure (IOP) after posterior capsule rupture can occur for several reasons.
When PCR happens, additional surgical steps are often required, including anterior vitrectomy. This can lead to:
- Retained viscoelastic blocking the drainage angle
- Inflammatory debris impairing aqueous outflow
- Vitreous strands temporarily disrupting fluid circulation
Transient pressure elevation is therefore more likely compared to uncomplicated surgery.
However, significant or sustained pressure rise is uncommon when prophylaxis is used.
At Blue Fin Vision®, all PCR patients receive preventative pressure control unless contraindicated:
- Acetazolamide 250 mg (BD to QDS depending on age/systemic health)
- Apraclonidine TDS
- Alternatives if allergy exists
Pressure is checked within 24–48 hours.
Studies examining IOP behaviour after complicated phacoemulsification show that early spikes are typically short-lived and manageable when treated promptly ¹. Shingleton et al. demonstrated that most post-operative IOP elevations resolve with short-term therapy ¹.
Pressure spikes are rarely vision-threatening if detected early ² ³.
The key principle is anticipation. When PCR occurs, pressure management is assumed necessary, and treated before it becomes problematic.
References
- Shingleton BJ, Pasternack JJ, Hung JW, O’Donoghue MW. Three- and five-year changes in intraocular pressure after clear corneal phacoemulsification in glaucoma patients. J Cataract Refract Surg. 2006;32(4):686-692.
- Kim SJ, Flach AJ, Jampol LM. Nonsteroidal anti-inflammatory drugs in ophthalmology. Surv Ophthalmol. 2010;55(2):108-133.
- Day AC, Donachie PHJ, Sparrow JM, Johnston RL. National Ophthalmology Database study of cataract surgery outcomes. Eye (Lond). 2015;29(4):552-560.
Related Topics
- What is Posterior Capsule Rupture?
- Why is my risk of retinal detachment increased after PCR?
- Why is there increased cystoid macular oedema (CMO) after PCR?
- Why might my eye pressure rise after PCR?
- When will I be seen again after PCR?
- What does PCR mean for my bilateral surgery?
- Will my vision be ok after posterior capsule rupture?
- Will my vision be ok after dropped nucleus surgery following PCR?
- How long will the operation take if PCR occurs?
- Can I go to Moorfields for a second opinion instead?
- If I seek a second opinion, can I still have my corrective surgery at Blue Fin Vision®?
- What happens to my fees if I cancel the second eye after PCR?
- Is my risk higher for the second eye if I had PCR in the first?
- What is anterior vitrectomy and why is it performed after PCR?
- What is a three-piece monofocal lens and why is it used after PCR?
- What is a sulcus supplementary (Sulcoflex) lens?
- What is dropped nucleus and why does it happen after PCR?
- What is expulsive suprachoroidal haemorrhage and why is it mentioned with PCR?
- Why does pseudoexfoliation increase the risk of PCR?
- Why do very dense cataracts increase the risk of PCR?
- Is posterior capsule rupture negligence?
