Postoperative course of intraocular pressure after cataract surgery with combined primary posterior capsulorhexis and posterior optic buttonholing

Abstract

The course of IOP after cataract surgery with combined PPCCC and POBH showed the technique to be as safe as conventional cataract surgery with in-the-bag IOL implantation.

Posterior optic buttonholing prevents intraocular pressure peaks after cataract surgery with primary posterior capsulorhexis

“…Considering previous clinical studies and the experience of the first 1,000 consecutive clinical cases, the present study supports the opinion that primary posterior capsulorhexis combined with posterior optic buttonholing is a wellcontrolled, safe, and effective procedure, with the potential of becoming a routine alternative to standard in-the-bag implantation of intraocular lenses [10,11,[13][14][15]. Particularly interesting were the findings concerning the axial IOL position and the resulting postoperative refractive stability: combined PPC/POBH cataract surgery significantly reduced the postoperative anterior movement of the IOL when compared to conventional in-the-bag IOL implantation [15].…”

“…Even though the performance of a primary capsule opening may be interpreted as a disturbance of the natural barrier between anterior and posterior segments, it could be shown that the posterior optic buttonholing evidently may effectively restitute this important natural barrier. This may be the explanation for the low complication rate during long-term follow-up, with regard to inflammatory and retinal complications [10,11,[13][14][15]. No intra-and postoperative complications were noticed in any of the eyes of the present study either.…”

“…When comparing eyes with solitary PPC cataract surgery, even a significantly lower postoperative anterior chamber reaction could be observed in eyes with combined PPC/ POBH cataract surgery [12]. The IOL-capsule diaphragm effectively prevented the possibility for a residual ophthalmic visco-surgical device (OVD) bolus captured behind the IOL to dislodge or dissipate into the anterior chamber in the first postoperative hours [12,13]. In case of a sole PPC, this may result in increased postoperative pressure [13].…”

“…The IOL-capsule diaphragm effectively prevented the possibility for a residual ophthalmic visco-surgical device (OVD) bolus captured behind the IOL to dislodge or dissipate into the anterior chamber in the first postoperative hours [12,13]. In case of a sole PPC, this may result in increased postoperative pressure [13].…”

Effect of primary posterior continuous curvilinear capsulorrhexis with posterior optic buttonholing on pilocarpine-induced IOL shift

“…[13][14][15][16][17][18][19] Therefore, removing the posterior capsule should inherently reduce the constricting factor of the capsule and thus enhance the axial mobility of the IOL.…”