Sep 18 2007
Cataract patients with no macular pathology can maintain macular integrity after surgery involving a posterior capsulorrhexis and posterior optic buttonholing, according to a surgeon speaking here. Optic buttonholing also produced similar outcomes to conventional in-the-bag IOL implantation, he noted.
At the European Society of Cataract and Refractive Surgeons meeting, Rupert M. Menapace, MD, discussed the results of a study he conducted with colleague Eva M. Stifter, MD. The study included 100 eyes of 50 patients with age-related cataract and normal macular function, all of whom underwent same-day bilateral cataract surgery.
One eye of each patient was randomly assigned to cataract surgery involving posterior optic buttonholing. In the contralateral eye, surgeons performed conventional in-the-bag IOL implantation, with the lens capsule maintained intact.
Optical coherence tomography imaging was performed at 1 day, 1 week and 1 month postop to evaluate changes in macular integrity.
The researchers found that no qualitative changes occurred in any patients at 1 month follow-up compared with baseline. Macular thickness measurements were also statistically similar, Dr. Menapace said.
No patients experienced vitreous herniation into the anterior chamber. Also, postoperative visual acuity and IOP were similar between groups.
In 58% of cases, a small, round central anterior vitreous surface puncture was seen. However, no cases showed prolapse out of the vitreous body, and the puncture did not significantly affect macular thickness measurements, Dr. Menapace said.
"Compared to standard in-the-bag implantations, primary posterior buttonholing of the optic through the primary posterior capsulorrhexis does not increase macular stress in terms of retinal thickness and morphology changes, as measured by high-resolution OCT," he said.