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August 1990

Effect of Sulcus vs Capsular Fixation on YAG-Induced Pressure Rises Following Posterior Capsulotomy

Author Affiliations

From the Gimbel Eye Centre, Calgary, Alberta (Drs Gimbel and Van Westenbrugge), and the Center for Clinical Research, Department of Ophthalmology, University of Illinois at Chicago (Dr Sanders and Ms Raanan).

Arch Ophthalmol. 1990;108(8):1126-1129. doi:10.1001/archopht.1990.01070100082039

• Neodymium-YAG capsulotomy for secondary cataracts can induce acute intraocular pressure rises, possibly by a blocking of the trabecular meshwork by debris. To test a hypothesis that bag-fixated intraocular lenses may act as a barrier to debris, thus reducing pressure rises after YAG capsulotomy, we conducted a study comparing pressures (at 1, 2, 3, 6, and 24 hours after YAG capsulotomy) between bag-fixated and sulcus-fixated cases. There were substantial and statistically significant intraocular pressure rises in the sulcus-fixated group starting at 1 and 2 hours after YAG capsulotomy, and peaking at 3 hours (mean rise, 7.83 mm Hg). There were no such peaks of intraocular pressure rise among bag-fixated cases (mean change, −0.32 mm Hg at 3 hours). There was a weak but significant (r = −.18) correlation between the change 1 hour after YAG capsulotomy in intraocular pressure and percent of enclosure of the intraocular lens optic among bag-fixated cases. Higher proportions (fourfold to fivefold) of cases with sulcus-fixated lenses had significant flare and particulate matter in the anterior chamber, compared with bag-fixated cases.

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