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 outpatient operating rooms. Methods: Of 51 consecutive candidates for surgery (excluding those with uncontrolled glaucoma), 26 were randomly assigned to wear the HIPR (Honan group) for 10 minutes before surgery. The remainder were placed in a control group. Intraocular pressure (IOP) was measured before (T1) and after (T2) HIPR 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 correlation 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, negating any reason to use the HIPR with topical anesthesia for cataract surgery.