Effect of Anesthesia on Intraocular Pressure Measured With Continuous Wireless Telemetry in Nonhuman Primates

PURPOSE: To compare the effects of both injectable anesthesia (ketamine/dexmedetomidine versus ketamine/xylazine) and inhalant anesthesia (isoflurane) on IOP using continuous, bilateral IOP telemetry in nonhuman primates (NHP). METHODS: Bilateral IOP was recorded continuously using a proven implantable telemetry system in five different sessions at least 2 weeks apart in four male rhesus macaques under two conditions: ketamine (3 mg/kg) with dexmedetomidine (50 μg/kg) or ketamine with xylazine (0.5 mg/kg) for induction, both followed by isoflurane for maintenance. IOP transducers were calibrated via anterior chamber manometry. Bilateral IOP was averaged over 2 minutes after injectable anesthetic induction and again after isoflurane inhalant had stabilized the anesthetic plane, then compared to baseline IOP measurements acquired immediately prior to anesthesia (both before and after initial human contact). RESULTS: When compared to pre-contact baseline measurements, ketamine/dexmedetomidine injectable anesthesia lowers IOP by 1.5 mm Hg on average (P < 0.05), but IOP did not change with ketamine/xylazine anesthesia. IOP returned to baseline levels shortly after isoflurane gas anesthesia was initiated. However, injectable anesthesia lowered IOP by an average of 5.4 mm Hg when compared to that measured after initial human contact (P < 0.01). CONCLUSIONS: Anesthetic effects on IOP are generally small when compared to precontact baseline but much larger when compared to IOP measures taken after human contact, indicating that IOP is temporarily elevated due to acute stress (similar to a “white coat effect”) and then decreased with anesthetic relaxation. Anesthetic induction with ketamine/xylazine and maintenance with isoflurane gas should be used when IOP is measured postanesthesia.