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Effect of General Anesthesia on Intraocular Pressure in Pediatric Patients: A Meta-analysis

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Posterboard#: A0571

Abstract Number: 2407 - A0571

AuthorBlock: Sukhumal Thanapaisal1,2, Julius Oatts1, Jing Zhao1, Claudio Ignacio Perez1, Qian Liu1,3, Travis C. Porco1, Ying Han1
1Ophthalmology, University of California San Francisco, San Francisco, California, United States; 2Ophthalmology, Khon Kaen University, Khon Kaen, Thailand; 3Ophthalmology, Henan Eye Institute, Henan, China;

DisclosureBlock: Sukhumal Thanapaisal, None; Julius Oatts, None; Jing Zhao, None; Claudio Ignacio Perez, None; Qian Liu, None; Travis C. Porco, None; Ying Han, None;

Purpose
The effect of general anesthesia agents on intraocular pressure in children is still controversial. We performed a meta-analysis to study the change in intraocular pressure (IOP) over time in children following general anesthesia (GA).

Methods
Pubmed, EMBASE, and CENTRAL databases were systematically searched following standard Cochrane guidelines to identify randomized controlled trials, prospective, and interventional studies. IOP, anesthesia time points and different agents during GA were recorded for non-glaucomatous pediatric patients (0-18 years old). The search included all studies through October 5th, 2018 with no date or language restrictions. Data of anesthetic agents use for induction and maintenance phase were extracted, together with IOP at different time points from prior to induction until deep anesthesia phase. Following data extraction, a linear mixed-effects regression analysis was performed.

Results
The search strategy identified 519 studies. Six studies (520 eyes) were included for quantitative synthesis. Seven categories of mixed and non-mixed agents identified by induction and maintenance drugs were compared. By analysis of overall agent, the IOP decreased over time after induction phase at a rate of 0.62 ± 0.095 mmHg/min (mean ± standard error, P-value < 0.001). This is a model of mean IOP as a function of time and agent, weighted by the inverse of variance of each reported outcome and clustered on publications.

Conclusions
This meta-analysis showed that IOP decreases over time following induction of GA in children. Moreover, the model we developed helps ophthalmologists better understand and estimate changes in IOP during GA.

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