Effect of capsulorhexis size on postoperative intraocular pressure

To determine whether capsulorhexis diameter has an effect on intraocular pressure (IOP) after phacoemulsification.

SSK Ankara Eye Hospital, Ankara, Turkey.

This prospective study comprised 58 patients selected for cataract extraction by phacoemulsification using a 5.2 mm temporal, clear corneal incision. Twenty-nine of 58 patients had a 4.0 mm capsulorhexis and the rest, 6.0 mm. All patients received a multipiece poly(methyl methacrylate) posterior chamber intraocular lens with a 5.0 mm diameter bioconvex optic and flexible haptics. Follow-up was 3 months. Postoperative IOP was obtained by Goldmann applanation tonometry 1 and 2 days before surgery and 1 and 7 days and 1, 2, and 3 months postoperatively.

A significant decrease in IOP was observed in both the 4.0 and 6.0 mm capsulorhexis groups 1 day postoperatively (P < .0001 and P < .0001, respectively). At 3 months postoperatively, IOP decreased significantly over preoperative values both in the 4.0 mm (P < .0001) and 6.0 mm capsulorhexis (P = .0014) groups. There was a statistical difference between the mean 1 month IOP values in the 4.0 mm (11.34 +/- 2.18 mm Hg [SD]) and 6.0 mm capsulorhexis (13.00 +/- 2.30 mm Hg) groups (P = .0059). A statistical difference between the groups also existed at 3 months postoperatively (P = .0028).

A 4.0 mm capsulorhexis resulted in lower postoperative IOP than a 6.0 mm capsulorhexis 1 month postoperatively.