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The effect of colonoscopy on intraocular pressure: an observational prospective study

  • Glaucoma
  • Published:
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Abstract

Purpose

Colonoscopy is an endoscopic examination of the bowel. It requires insufflation of the large bowel lumen with gas which leads to intraabdominal hypertension (IAH). There is evidence suggesting that IAH positively correlates with intracranial pressure (ICP) and possibly with intraocular pressure (IOP). The aim of this study was to examine the effect of routine screening colonoscopy performed under sedation on the IOP in healthy individuals.

Patients and methods

This was a prospective, single site, observational study. Healthy adults undergoing routine colonoscopy performed under sedation including propofol, fentanyl, and midazolam were recruited. Right eye IOP measurements were performed using Tonopen XL® in a left decubitus position at 5 time points during the procedure. Statistical analysis was performed using Student’s t-test for paired samples.

Results

Twenty-three Caucasians were recruited. There are 14 males (60%) with a mean age of 60.4 ± 10.4 years (range 36–74). Colonoscopy was conducted under sedation and completed in 22 subjects. Mean baseline IOP was 19.9 ± 4.7 mmHg, 15.8 ± 4.8 mmHg immediately after sedation, 13.5 ± 2.3 mmHg when the colonoscope had reached the cecum, 15.4 ± 5.0 mmHg 5 min after colonoscopy beginning, and 16.5 ± 5.5 mmHg when located in the rectum. The IOP reduction during the procedure was statistically significant (P < 0.01).

Conclusion

Routine colonoscopy performed under sedation using propofol, fentanyl, and midazolam does not increase the IOP in healthy adults.

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Author notes

  1. Ilan Kent and Noa Geffen contributed equally to this work.

Authors and Affiliations

  1. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Ilan Kent, Noa Geffen, Assaf Stein, Yaron Rudnicki, Asaf Friehmann & Shmuel Avital

  2. Department of Surgery, Meir Medical Center, Kfar Saba, Israel

    Ilan Kent, Yaron Rudnicki & Shmuel Avital

  3. Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel

    Noa Geffen

  4. Department of Gastroenterology, Meir Medical Center, Kfar Saba, Israel

    Assaf Stein

  5. Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel

    Asaf Friehmann

Authors
  1. Ilan Kent
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  2. Noa Geffen
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  3. Assaf Stein
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  4. Yaron Rudnicki
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  6. Shmuel Avital
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Correspondence to Ilan Kent.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Meir Medical Center institutional review board (IRB) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual precipitants included in the study.

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Kent, I., Geffen, N., Stein, A. et al. The effect of colonoscopy on intraocular pressure: an observational prospective study. Graefes Arch Clin Exp Ophthalmol 258, 607–611 (2020). https://doi.org/10.1007/s00417-019-04542-5

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  • DOI: https://doi.org/10.1007/s00417-019-04542-5

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