Limits...
Evaluation of a new method of irrigation and aspiration for removal of ophthalmic viscoelastic device during cataract surgery in a porcine model.

Mitani A, Suzuki T, Tasaka Y, Uda T, Hiramatsu Y, Kawasaki S, Ohashi Y - BMC Ophthalmol (2014)

Bottom Line: Technique 1 resulted in a straight flow of fluid behind the IOL, while Technique 2 resulted in a vortex flow.The average amount of OVD retained inside the capsule after using Technique 2 or 3 was significantly lower than after using Technique 1 (p <0.0001).Technique 2 proved to remove more effectively fluorescein bead-labelled OVD under the IOL than Technique 1.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan. t-suzuki@m.ehime-u.ac.jp.

ABSTRACT

Background: To determine if a method for irrigation and aspiration (I/A) during cataract surgery provides effective removal of ophthalmic viscoelastic device (OVD).

Methods: Japanese porcine eyes were used to evaluate I/A performance with Technique 1 (the I/A tip placed on the center of the anterior surface of the IOL), Technique 2 (the I/A tip alternately pressed near the edge of the IOL optic anterior surface on one side and then the other to tilt the IOL back and forth), and Technique 3 (the I/A tip inserted behind the IOL optic, between it and the posterior capsule). Techniques 1 and 2 were compared using the Miyake-Apple posterior view video technique to visualize the flow of irrigation fluid containing triamcinolone acetonide particles behind the IOL. To check the efficacy of OVD removal from behind the IOL for of all three I/A techniques, OVD with fluorescein beads were inserted inside the lens capsule before implantation of the IOL. After each I/A technique, eyes were prepared for Miyake-Apple viewing and pictures of the lens capsule were taken using fluorescent microscopy. Residual fluorescein beads in the capsular bag were analyzed.

Results: Technique 1 resulted in a straight flow of fluid behind the IOL, while Technique 2 resulted in a vortex flow. The average amount of OVD retained inside the capsule after using Technique 2 or 3 was significantly lower than after using Technique 1 (p <0.0001).

Conclusions: Technique 2 proved to remove more effectively fluorescein bead-labelled OVD under the IOL than Technique 1.

Show MeSH

Related in: MedlinePlus

Movement of particles across a grid during next 0.2 seconds in a porcine eye showing Technique 1 (left) and 2 (right). The yellow arrows indicate the distance and direction in which particles moved for 0.2 seconds.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4232668&req=5

Fig3: Movement of particles across a grid during next 0.2 seconds in a porcine eye showing Technique 1 (left) and 2 (right). The yellow arrows indicate the distance and direction in which particles moved for 0.2 seconds.

Mentions: Irrigation solutions behind the IOL in all tested eyes were visualized (Additional file 1). We checked flow of irrigation solution using both methods in three different eyes. Since flow pattern of particles in each technique were similar, a representative eye was estimated for movement of particles. Figure 2 shows a histogram of the pixel intensity at each time. We quantified pixel intensity of TA particles behind IOL in technique 1 or 2. The pixel intensity using Technique 2 increased and decreased in a shorter time span compared to Technique 1. To evaluate the dynamic flow of irrigation solution, we measured the distance and direction TA particles traveled for 6 frames (0.2 seconds). Figure 3 shows the vector in which particles crossed the grid lines as yellow arrows. The flow of the irrigation solution using Technique 1 was in one direction at an average distance of 0.66 mm (±0.23 mm) in the 0.2 seconds. For Technique 2 the flow was a focal vortex with an average distance of 0.76 mm (±0.27 mm). There were no statistically significant differences between two methods.Figure 2


Evaluation of a new method of irrigation and aspiration for removal of ophthalmic viscoelastic device during cataract surgery in a porcine model.

Mitani A, Suzuki T, Tasaka Y, Uda T, Hiramatsu Y, Kawasaki S, Ohashi Y - BMC Ophthalmol (2014)

Movement of particles across a grid during next 0.2 seconds in a porcine eye showing Technique 1 (left) and 2 (right). The yellow arrows indicate the distance and direction in which particles moved for 0.2 seconds.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4232668&req=5

Fig3: Movement of particles across a grid during next 0.2 seconds in a porcine eye showing Technique 1 (left) and 2 (right). The yellow arrows indicate the distance and direction in which particles moved for 0.2 seconds.
Mentions: Irrigation solutions behind the IOL in all tested eyes were visualized (Additional file 1). We checked flow of irrigation solution using both methods in three different eyes. Since flow pattern of particles in each technique were similar, a representative eye was estimated for movement of particles. Figure 2 shows a histogram of the pixel intensity at each time. We quantified pixel intensity of TA particles behind IOL in technique 1 or 2. The pixel intensity using Technique 2 increased and decreased in a shorter time span compared to Technique 1. To evaluate the dynamic flow of irrigation solution, we measured the distance and direction TA particles traveled for 6 frames (0.2 seconds). Figure 3 shows the vector in which particles crossed the grid lines as yellow arrows. The flow of the irrigation solution using Technique 1 was in one direction at an average distance of 0.66 mm (±0.23 mm) in the 0.2 seconds. For Technique 2 the flow was a focal vortex with an average distance of 0.76 mm (±0.27 mm). There were no statistically significant differences between two methods.Figure 2

Bottom Line: Technique 1 resulted in a straight flow of fluid behind the IOL, while Technique 2 resulted in a vortex flow.The average amount of OVD retained inside the capsule after using Technique 2 or 3 was significantly lower than after using Technique 1 (p <0.0001).Technique 2 proved to remove more effectively fluorescein bead-labelled OVD under the IOL than Technique 1.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan. t-suzuki@m.ehime-u.ac.jp.

ABSTRACT

Background: To determine if a method for irrigation and aspiration (I/A) during cataract surgery provides effective removal of ophthalmic viscoelastic device (OVD).

Methods: Japanese porcine eyes were used to evaluate I/A performance with Technique 1 (the I/A tip placed on the center of the anterior surface of the IOL), Technique 2 (the I/A tip alternately pressed near the edge of the IOL optic anterior surface on one side and then the other to tilt the IOL back and forth), and Technique 3 (the I/A tip inserted behind the IOL optic, between it and the posterior capsule). Techniques 1 and 2 were compared using the Miyake-Apple posterior view video technique to visualize the flow of irrigation fluid containing triamcinolone acetonide particles behind the IOL. To check the efficacy of OVD removal from behind the IOL for of all three I/A techniques, OVD with fluorescein beads were inserted inside the lens capsule before implantation of the IOL. After each I/A technique, eyes were prepared for Miyake-Apple viewing and pictures of the lens capsule were taken using fluorescent microscopy. Residual fluorescein beads in the capsular bag were analyzed.

Results: Technique 1 resulted in a straight flow of fluid behind the IOL, while Technique 2 resulted in a vortex flow. The average amount of OVD retained inside the capsule after using Technique 2 or 3 was significantly lower than after using Technique 1 (p <0.0001).

Conclusions: Technique 2 proved to remove more effectively fluorescein bead-labelled OVD under the IOL than Technique 1.

Show MeSH
Related in: MedlinePlus