Posterior optic buttonholing prevents intraocular pressure peaks after cataract surgery with primary posterior capsulorhexis
- 87 Downloads
The performance of a primary posterior capsulorhexis (PPC) with and without posterior optic buttonholing (POBH) may significantly influence the intraocular pressure (IOP) after cataract surgery in age-related cataract patients.
The prospective randomized clinical study was performed at the department of Ophthalmology, Medical University of Vienna, Austria. Thirty consecutive cataract patients with bilateral same-day cataract surgery (60 eyes) under topical anesthesia were enrolled. In randomized order, cataract surgery with combined PPC/POBH was performed in one eye; in the other eye, cataract surgery was performed with PPC and in-the-bag implantation of the intraocular lens (IOL). Standardized IOP measurements by Goldmann applanation tonometry were performed preoperatively, 1, 2, 4, 6, 8 and 24 hours postoperatively, as well as 1 week and 1 month postoperatively.
During the first 24 hours after surgery, all IOP measurements were significantly lower in eyes with combined PPC/POBH when compared to eyes with solitary PPC (p < 0.001). No IOP peaks of more than 27 mmHg were observed with combined PPC/POBH. In contrast, in eyes with PPC and in-the-bag IOL implantation, seven patients had an IOP peak of more than 27 mmHg and four IOP peaks of more than 30 mmHg. One week and 1 month postoperatively, IOP measurements were statistically comparable, and no significant differences could be observed between the two groups (p > 0.05).
Postoperative IOP peaks after cataract surgery with sole PPC can be effectively prevented by the buttonholing of the IOL through the posterior capsulorhexis.
KeywordsCataract surgery Primary posterior capsulorhexis Posterior optic buttonholing
- 2.Gimbel HV (1990) Posterior capsule tears using phaco-emulsification: cause, prevention and management. Eur J Implant Refract Surg 2:63–69Google Scholar
- 8.Wirtitsch MG, Menapace R, Georgopoulos M, Rainer G, Buehl W, Heinzl H (2007) Intraocular pressure rise after primary posterior continuous curvilinear capsulorhexis with a fixed dorzolamide-timolol combination: randomized safety study with intraindividual comparison using an angulated and a nonangulated intraocular lens. J Cataract Refract Surg 33(10):1754–1759CrossRefPubMedGoogle Scholar
- 9.Stifter E, Menapace R, Luksch A, Neumayer T, Vock L, Sacu S (2007) Objective assessment of intraocular flare after cataract surgery with combined primary posterior capsulorhexis and posterior optic buttonholing in adults. Br J Ophthalmol 91(11):1481–1484, Epub 2007 May 15CrossRefPubMedGoogle Scholar
- 11.Menapace R (2008) Posterior capsulorhexis combined with optic buttonholing: an alternative to standard in-the-bag implantation of sharp-edged intraocular lenses? A critical analysis of 1000 consecutive cases. Graefes Arch Clin Exp Ophthalmol 246(6):787–801, Epub 2008 Apr 19CrossRefPubMedGoogle Scholar