Siegfried Mariacher, Peter Laubichler, Jascha Wendelstein, M Mariacher, Matthias Bolz,
"Preoperative intraocular pressure as a strong predictive factor for intraocular pressure rise during vacuum application in femtosecond laser-assisted cataract surgery"
, in WILEY, 111 RIVER ST, HOBOKEN, USA, NJ, 07030-5774, in Acta Ophthalmologica, Vol. 97, Nummer 8, WILEY, 111 RIVER ST, HOBOKEN, USA, NJ, 07030-5774, Seite(n) e1123-e1129, 2019, ISSN: 1755-375X
Preoperative intraocular pressure as a strong predictive factor for intraocular pressure rise during vacuum application in femtosecond laser-assisted cataract surgery
Sprache des Titels:
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.