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Buttonholing does not affect IOL shift during ciliary muscle contraction
No significant difference was found in IOL shift between in-the-bag IOLs and IOLs with combined primary posterior continuous curvilinear capsulorrhexis and posterior optic buttonholing, according to a study.
“Pilocarpine-induced ciliary muscle contraction after implantation of a nonaccommodating three-piece IOL after cataract surgery with combined posterior capsulorrhexis and posterior optic buttonholing led to a slight significant backward IOL shift and thus to disaccommodation,” the study authors said. “The detected IOL shift did not differ significantly from the shift of in-the-bag IOLs.”
The randomized prospective controlled clinical trial analyzed 40 eyes of 20 patients. All eyes received the AF-1 YA-60BB IOL (Hoya Medical Europe). In each patient, surgery in one eye involved primary posterior continuous curvilinear capsulorrhexis and posterior buttonholing, while the control eye received conventional in-the-bag IOL implantation.
Anterior chamber depth was assessed with partial coherence interferometry before and after application of pilocarpine 2% at least 6 months after surgery.
Control and study eyes demonstrated a statistically significant backward IOL shift after application of pilocarpine. There was a mean shift of 118 ± 117 µm in control eyes (P < .05) and 78 ± 78 µm in study eyes (P < .05). The difference in shift between the control and study eyes was not statistically significant.