In this study, we evaluate the association between biometrics and intraocular pressure (IOP) during femtosecond laser-assisted cataract surgery (FLACS) in normal patients and those with open-angle glaucoma (OAG). A retrospective cross-sectional study was conducted. A total of 103 patients who had received elective FLACS were enrolled, and those with OAG who received FLACS were further divided into a subgroup. The perioperative IOP of FLACS was measured before, during, and after the suction procedure. Demographic data and preoperative biometrics were collected from the medical records. The generalized linear model was applied to yield the adjusted odds ratio (aOR) and corresponding 95% confidence interval (CI) of each biometric for the IOP elevation in the whole group and the OAG subgroup. The mean preoperative IOP was 20.96 ± 4.79 mmHg, which rose to 55.37 ± 11.58 mmHg during suction, and decreased to 23.75 ± 6.42 mmHg after suction; the IOP both during and after suction was significantly higher than the presuction IOP (both p < 0.001). The mean IOP elevation was 34.41 ± 9.70 mmHg in the whole study population, and the difference in IOP elevation between OAG and nonglaucoma subgroups was not significant (p = 0.159). In the whole group, the presuction IOP, postdilated pupil size (PPS), and central corneal thickness (CCT) were positively corrected to higher IOP elevation (all p < 0.05), while axial length (AL) was negatively related to IOP elevation (aOR: 0.020, 95% CI: 0.008–0.699, p = 0.042). For the OAG subgroup, the longer AL was more significantly correlated to lower IOP elevation compared to those without glaucoma (aOR: 0.231, 95% CI: 0.106–0.502, p = 0.006). In conclusion, presuction IOP, PPS, and CCT are related to higher IOP during FLAC, while the AL is negatively correlated to the IOP elevation in FLACS, especially for patients with OAG. Reviewing these parameters before FLACS may enable physicians to find patients who are at risk of IOP elevation.
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