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Comparison of OVD and BSS for maintaining the anterior chamber during IOL implantation.

Lee HY, Choy YJ, Park JS - Korean J Ophthalmol (2011)

Bottom Line: Surgical results were compared between the two groups.The values of endothelial cell density, central corneal thickness, anterior chamber inflammation, myopic shift, and posterior capsule opacification were not significantly different between the two groups.Compared with the use of OVD for IOL implantation, use of BSS during IOL implantation resulted in reductions in postoperative IOP spike and OVD removal time.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To compare surgical results between conventional intraocular lens (IOL) implantation using an ophthalmic viscosurgical device (OVD) and IOL implantation using a balanced salt solution (BSS) after irrigation/aspiration (I/A) of the lens cortex.

Methods: A randomized prospective study was conducted on 62 patients who underwent cataract surgery. Following completion of conventional I/A of the lens cortex, we divided patients into two groups according to whether or not BSS was used. In group A (n = 31), the anterior chamber and the capsular bag were completely filled with an OVD before IOL implantation. On the other hand, in group B (n = 31), BSS was irrigated into the anterior chamber through a previous side port during IOL implantation. Surgical results were compared between the two groups.

Results: In both groups, IOP peaked six hours after surgery. The occurrence of an IOP spike by postoperative day one was observed in six cases (6 / 31) in group A and in no cases (0 / 31) in group B, a difference that was statistically significant (p = 0.024). The values of endothelial cell density, central corneal thickness, anterior chamber inflammation, myopic shift, and posterior capsule opacification were not significantly different between the two groups.

Conclusions: Compared with the use of OVD for IOL implantation, use of BSS during IOL implantation resulted in reductions in postoperative IOP spike and OVD removal time.

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Related in: MedlinePlus

(A) Following irrigation/aspiration of the cortex, the anterior chamber is irrigated with balanced salt solution (BSS) through a side port using a 27-gauge Amvisc Plus needle before intraocular lens implantation. (B) Insertion of the intraocular lens into the capsular bag while the anterior chamber is maintained with BSS.
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Figure 1: (A) Following irrigation/aspiration of the cortex, the anterior chamber is irrigated with balanced salt solution (BSS) through a side port using a 27-gauge Amvisc Plus needle before intraocular lens implantation. (B) Insertion of the intraocular lens into the capsular bag while the anterior chamber is maintained with BSS.

Mentions: Following in-the-bag phaco of the nucleus using the divide and conquer technique, the cortex was removed using I/A. In group A, the anterior chamber and the capsular bag were completely filled with Amvisc Plus, and the IOL was then implanted into the capsular bag. In group B, the anterior chamber and the capsular bag were not filled with OVD; however, BSS was used for maintenance of the anterior chamber shape. The surgeon evaluated the patency of a 27-gauge Amvisc Plus needle connected to a three-way irrigation line with a 140 cm irrigation bottle height. After a small amount of OVD (about 0.05 mL) was placed on an IOL injector cartridge, the surgeon advanced the tip of the IOL injector into the anterior chamber through a temporal wound using his right hand. After a slight deepening of the anterior chamber by slight pressure from the injector, the surgeon inserted the 27-gauge Amvisc Plus needle into the anterior chamber through a side port, using the left hand for continuous irrigation with BSS, while maintaining irrigation using the phaco machine foot switch (Fig. 1A and 1B). The IOL, a one-piece, foldable, hydrophilic acrylic, aspheric Teklens II lens (Tekia Inc., Irvine, CA, USA), was then fully inserted into the capsular bag. Following IOL implantation in both groups, the IOL was centered using the IOL rotator, and residual Amvisc Plus was removed as thoroughly as possible. In all cases, the corneal wound was hydrated at the conclusion of the surgery. Subconjunctival injection consisting of 8 mg/0.2 mL triamcinolone acetonide was administered.


Comparison of OVD and BSS for maintaining the anterior chamber during IOL implantation.

Lee HY, Choy YJ, Park JS - Korean J Ophthalmol (2011)

(A) Following irrigation/aspiration of the cortex, the anterior chamber is irrigated with balanced salt solution (BSS) through a side port using a 27-gauge Amvisc Plus needle before intraocular lens implantation. (B) Insertion of the intraocular lens into the capsular bag while the anterior chamber is maintained with BSS.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3039189&req=5

Figure 1: (A) Following irrigation/aspiration of the cortex, the anterior chamber is irrigated with balanced salt solution (BSS) through a side port using a 27-gauge Amvisc Plus needle before intraocular lens implantation. (B) Insertion of the intraocular lens into the capsular bag while the anterior chamber is maintained with BSS.
Mentions: Following in-the-bag phaco of the nucleus using the divide and conquer technique, the cortex was removed using I/A. In group A, the anterior chamber and the capsular bag were completely filled with Amvisc Plus, and the IOL was then implanted into the capsular bag. In group B, the anterior chamber and the capsular bag were not filled with OVD; however, BSS was used for maintenance of the anterior chamber shape. The surgeon evaluated the patency of a 27-gauge Amvisc Plus needle connected to a three-way irrigation line with a 140 cm irrigation bottle height. After a small amount of OVD (about 0.05 mL) was placed on an IOL injector cartridge, the surgeon advanced the tip of the IOL injector into the anterior chamber through a temporal wound using his right hand. After a slight deepening of the anterior chamber by slight pressure from the injector, the surgeon inserted the 27-gauge Amvisc Plus needle into the anterior chamber through a side port, using the left hand for continuous irrigation with BSS, while maintaining irrigation using the phaco machine foot switch (Fig. 1A and 1B). The IOL, a one-piece, foldable, hydrophilic acrylic, aspheric Teklens II lens (Tekia Inc., Irvine, CA, USA), was then fully inserted into the capsular bag. Following IOL implantation in both groups, the IOL was centered using the IOL rotator, and residual Amvisc Plus was removed as thoroughly as possible. In all cases, the corneal wound was hydrated at the conclusion of the surgery. Subconjunctival injection consisting of 8 mg/0.2 mL triamcinolone acetonide was administered.

Bottom Line: Surgical results were compared between the two groups.The values of endothelial cell density, central corneal thickness, anterior chamber inflammation, myopic shift, and posterior capsule opacification were not significantly different between the two groups.Compared with the use of OVD for IOL implantation, use of BSS during IOL implantation resulted in reductions in postoperative IOP spike and OVD removal time.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To compare surgical results between conventional intraocular lens (IOL) implantation using an ophthalmic viscosurgical device (OVD) and IOL implantation using a balanced salt solution (BSS) after irrigation/aspiration (I/A) of the lens cortex.

Methods: A randomized prospective study was conducted on 62 patients who underwent cataract surgery. Following completion of conventional I/A of the lens cortex, we divided patients into two groups according to whether or not BSS was used. In group A (n = 31), the anterior chamber and the capsular bag were completely filled with an OVD before IOL implantation. On the other hand, in group B (n = 31), BSS was irrigated into the anterior chamber through a previous side port during IOL implantation. Surgical results were compared between the two groups.

Results: In both groups, IOP peaked six hours after surgery. The occurrence of an IOP spike by postoperative day one was observed in six cases (6 / 31) in group A and in no cases (0 / 31) in group B, a difference that was statistically significant (p = 0.024). The values of endothelial cell density, central corneal thickness, anterior chamber inflammation, myopic shift, and posterior capsule opacification were not significantly different between the two groups.

Conclusions: Compared with the use of OVD for IOL implantation, use of BSS during IOL implantation resulted in reductions in postoperative IOP spike and OVD removal time.

Show MeSH
Related in: MedlinePlus