Abstract

P 179

Anterior chamber depth and IOL position after cataract surgery with combined primary posterior capsulorhexis and posterior optic buttonholing

Stifter E., Menapace R.
Department of Ophthalmology, Medical University of Vienna, Austria

Objective: After standardized cataract surgery with combined primary posterior capsulorhexis (PCCC) and posterior buttonholing of the IOL optic (POBH), anterior chamber depth (ACD) and axial position of the intraocular lens (IOL) were evaluated prospectively in 23 patients with age-related bilateral cataracts.
Methods: In randomized order, conventional cataract surgery with in-the-bag IOL implantation was performed in one eye; in the fellow eye, cataract surgery was performed with combined PCCC and POBH. Anterior chamber depth was measured preoperatively and 2, 6, 24 hours, 1 week, and 1 month postoperatively, using partial coherence interferometry (AC-Master^®, Fa. Zeiss).
Results: Postoperatively, a significant fibrosis-related anterior movement of the IOL was observed in eyes with conventional in-the-bag IOL implantation (p<0.001; mean difference: 0.48±0.6 mm). In contrast, the axial IOL position was stable in the PCCC/POBH eyes: no significant difference was found between the ACD measurements 2 hours (4.651±0.47mm) and 1 month (4.73±0.532 mm) postoperatively (p=0.6; mean difference: -0.08±0.24 mm).
Conclusions: Posterior optic buttonholing through a PCCC results in a stable diaphragm of lens capsule and IOL optic. This sealed optic capsule diaphragm may prevent fibrosis of the anterior lens capsule and the fibrosis-related anterior movement of IOL, effectively stabilizing that axial IOL position. The early stabilization of the IOL position may improve the prediction of refractive error so that glasses may be prescribed in the early postoperative period.

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