Necessity of the Honan intraocular pressure reducer in cataract surgery using topical anesthesia

Purpose: To assess the use of the Honan intraocular pressure reducer (HIPR) for clear corneal cataract surgery using topical anesthesia. Setting: University of North Carolina Hospitals Ambulatory Care Clinic outp atient operating rooms. Methods: Of 51 consecutive candidates for surgery (excluding those with unc ontrolled glaucoma), 26 were randomly assigned to wear the HIPR (Honan grou p) for 10 minutes before surgery. The remainder were placed in a control gr oup. Intraocular pressure (IOP) was measured before (T1) and after (T2) HIP R application and after patient preparation for surgery (T3). Results: Mean IOP was the same in the Honan and control groups at T1 and T3 . At T2, the groups had a significantly different mean IOP (P = 1.8 x 10(-5 )). In the Honan group, mean IOP decreased significantly (P = 2.8 X 10(-7)) between T1 and T2, and there was a significant correlation among patients at T1 and T2 (P < .0005). Between T2 and T3, the Honan group experienced a significant recovery (P = 3.5 x 10(-9)); there was a significant correlatio n between the decreases from T1 to T2 and the increases from T2 to T3 (P < .0005). Mean IOP in the control group did not change between T1 and T2 but increased significantly between T2 and T3 (P = .004). Conclusion: When using topical anesthesia, the HIPR transiently reduced IOP . However, the IOP-reducing effect resolved by the time of surgery, negatin g any reason to use the HIPR with topical anesthesia for cataract surgery.