Medical control of intraocular pressure after cataract surgery Sally Byrd, MD, Kuldev Singh, MD, MPH I ntraocular pressure (lOP) elevation after cataract surgery, particularly with the use of viscoelastic material, has been well described. I - 5 This elevation potentially increases the risk of retinal artery occlusion From Stanford University Medical Center, Palo Alto Veteram Affairs Health Care System, Palo Alto, California, USA. Presented at the annual meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, USA, May 1997. Neither author has a financial interest in any product mentioned. Reprint requests to Sally Byrd, MD, Ophthalmology Section 112B1, Palo Alto VA Health Care System, 3801 Miranda Avenue, Palo Alto, California 94304, USA . and ischemic optic neuropathy<' and may be particu- larly harmful in patients with pre-existing glaucoma- tous nerve damage. In addition, it is a chief cause of pain in the immediate postoperative period. Many, although not all, surgeons use ocular hypo- tensive agents at the time of cataract surgery to prevent or lessen lOP increase. However, there is no standard accepted regimen, and the results reported in the literature have been contradictory. Although Lewen and Insler? described successfully using postoperative acetazolamide to lessen postoperative lOP increase, they gave an .initial intravenous bolus and their total number of patients was small. Fry8 compared several medications including oral acetazolamide and apra- J CATARACT REFRACT SURG--VOL 24 , NOVEMBER 1998 1493