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Posterior optic buttonholing may prevent IOP spikes in first 24 hours after cataract surgery

Graefes Arch Clin Exp Ophthalmol. 2010;248(11):1595-1600.

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Posterior optic buttonholing combined with primary posterior capsulorrhexis may provide better control of IOP in the immediate postoperative period after removal of age-related cataracts.

In a study of 30 patients who underwent bilateral same-day cataract surgery, a primary posterior capsulorrhexis was performed in one randomized eye, while the technique was combined with posterior optic buttonholing in the contralateral eye. Measurements of IOP during the first 24 hours postop, performed by Goldmann applanation tonometry, were significantly lower in the combined technique eyes compared with eyes in the single technique group.

Among eyes in which both posterior optic buttonholing and primary posterior capsulorrhexis were performed, there were no IOP peaks higher than 27 mm Hg. However, in the single technique group, seven eyes had an IOP higher than 27 mm Hg in the first 24 hours, and four eyes had a peak higher than 30 mm Hg.

There was no subsequent benefit in the combined technique eyes compared with single technique eyes after the initial 24 hours. IOP measurements were statistically comparable at 1 week and 1 month after surgery.