title: Anterior chamber depth and change in axial intraocular lens position after cataract surgery with primary posterior capsulorhexis and posterior optic buttonholing.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Combined PPCCC and POBH for cataract surgery significantly reduced postoperative anterior movement of the IOL.
authors.affiliation: Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
authors.forename: Eva
authors.initials: E
authors.lastname: Stifter
authors.forename: Rupert
authors.initials: R
authors.lastname: Menapace
authors.forename: Alexandra
authors.initials: A
authors.lastname: Luksch
authors.forename: Thomas
authors.initials: T
authors.lastname: Neumayer
authors.forename: Stefan
authors.initials: S
authors.lastname: Sacu
mesh_terms: D000368:Aged; D000867:Anterior Chamber / Q000473:pathology*; D019923:Capsulorhexis / Q000379:methods*; D005260:Female; D005548:Foreign-Body Migration / Q000517:prevention & control*; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008866:Microsurgery; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies