Anterior chamber depth and change in axial intraocular lens position after cataract surgery with primary posterior capsulorhexis and posterior optic buttonholing

Purpose

To compare axial position changes of the intraocular lens (IOL) by measuring anterior chamber depth (ACD) after small-incision cataract surgery with primary posterior continuous curvilinear capsulorhexis (PPCCC) and posterior optic buttonholing (POBH) of the IOL and after conventional cataract surgery with phacoemulsification and in-the-bag IOL implantation.

Setting

Department of Ophthalmology, Medical University of Vienna, Austria.

Methods

This prospective comparative study comprised 23 patients (46 eyes) with age-related cataract who had bilateral cataract surgery and implantation of an acrylic IOL (YA-60BB, Hoya). In randomized order, cataract surgery with PPCCC and POBH of the IOL was performed in 1 eye of each patient. In the fellow eyes, conventional phacoemulsification cataract surgery with in-the-bag IOL implantation was performed. The ACD was measured 1 to 2, 6, and 24 hours as well as 7 and 30 days postoperatively using high-resolution partial coherence laser interferometry. A baseline measurement was taken preoperatively in all patients.

Results

Ten patients completed 10 to 12 months of follow-up. Postoperatively, the axial IOL position was stable in eyes with PPCCC–POBH (P>.05). In contrast, a significant axial shift of the IOL in the anterior direction was observed in control eyes with in-the-bag IOL implantation (P<.001). The resulting refractive shift was significantly higher in control eyes than in eyes with PPCCC–POBH (P<.001).

Conclusion

Combined PPCCC and POBH for cataract surgery significantly reduced postoperative anterior movement of the IOL.