Effects of functional endoscopic sinus surgery on intraocular pressure

Objective: To investigate whether functional endoscopic sinus surgery (FESS) for the treatment of chronic rhinosinusitis will induce changes in intraocular pressure (IOP). Design: Prospective, nonrandomized, preoperative and postoperative study. Setting: University-affiliated medical center. Patients: Thirty patients who underwent FESS for chronic rhinosinusitis with or without polyps were prospectively enrolled in this study. Patients with diabetes mellitus, hypertension, glaucoma, previous ocular trauma, history of ocular surgery, and previous use of topical corticosteroid eyedrops were excluded. Main Outcome Measures: The IOPs were measured by Goldmann tonometry preoperatively, postoperatively on days 1 and 2, and on day 3 after the removal of the nasal packs. Physiological factors such as heart rate and systolic and diastolic blood pressures, which may have some effects on the IOPs, were also recorded. Results: Ten women and 20 men with a mean age of 39.7 years were enrolled in the study. Twenty-one patients had bilateral chronic rhinosinusitis and 9 patients had unilateral sinus disease. The postoperative ocular discomforts were epiphora (13 of 30 [43%]) and eye pressure (6 of 30 [20%]). The mean ± SD IOP of the eye on the side of the operated-on sinus was 13.63 ± 2.33 mm Hg preoperatively. Postoperatively, the mean ± SD IOPs were 14.08 ± 2.52 mm Hg on day 1, 13.96 ± 2.64 mm Hg on day 2, and 14.10 ± 2.91 mm Hg on day 3 after removal of the nasal packs (P = .82). The IOP-related factors of heart rate and systolic and diastolic blood pressures also showed no significant difference. Conclusions: Although FESS may cause variations in the IOP compartment, the changes in IOP are not statistically significant. Therefore, FESS is a safe surgical procedure with respect to ocular physiological function.