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Preoperative intraocular pressure as a strong predictive factor for intraocular pressure rise during vacuum application in femtosecond laser‐assisted cataract surgery
Author(s) -
Mariacher Siegfried,
Laubichler Peter,
Wendelstein Jascha,
Mariacher Martina,
Bolz Matthias
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14149
Subject(s) - intraocular pressure , medicine , ophthalmology , cataract surgery , surgery
Purpose To evaluate the effect of preoperative intraocular pressure ( IOP ) and the vacuum level on IOP during femtosecond laser‐assisted cataract surgery. Methods Intraocular pressure was measured in 40 enucleated porcine eyes by intracameral manometry prior, during and after vacuum application using the VICTUS femtosecond laser platform (Bausch&Lomb, Technolas Perfect Vision GmbH, Germany). Twenty combinations of different preoperative IOP levels (12, 16, 20 and 24 mmHg) and different vacuum levels (350–550 mbar) were investigated. Results Multivariate regression analysis indicated that both the vacuum level (beta = 0.138; p < 0.001) but much stronger the preoperative IOP (beta = 0.861; p < 0.001) were predictive factors for IOP rise during vacuum application. Mean IOP was 28.23 ± 3.86, 34.23 ± 3.92, 40.35 ± 4.41 and 46.82 ± 4.11 mmHg in groups with baseline IOP of 12, 16, 20 and 24 mmHg, respectively. In the 350, 450 and 550 mbar group, and mean IOP was 35.85 ± 7.85, 37.33 ± 7.90 and 39.00 ± 8.04 mmHg, respectively. Lowering the preoperative IOP by 2 mmHg and reducing the vacuum from maximum to minimum resulted in a similar reduction in IOP during vacuum application (−3.10 ± 0.79 mmHg versus −3.15 ± 0.88 mmHg; p = 0.015). Furthermore, decreasing the baseline IOP from 20 to 12 mmHg resulted in a 30.0% reduction in intraoperative IOP . Conclusion Preoperative IOP was a stronger predictive factor for intraoperative IOP rise than the applied vacuum level. Measurements and critical interpretation of preoperative IOP in a preliminary examination could help estimating the individual risk of significant IOP rise during femtosecond laser‐assisted cataract surgery and could help taking early countermeasures in selected cases. Due to the porcine ex vivo model, further studies are needed to verify these findings.