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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.

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Related in: MedlinePlus

Photograph of fluorescent pixel after removal of the fluorescein bead-labelled OVD in all five eyes of each group (A, B, C, D,and E). Black pixel showing residual fluorescein beads.
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Fig4: Photograph of fluorescent pixel after removal of the fluorescein bead-labelled OVD in all five eyes of each group (A, B, C, D,and E). Black pixel showing residual fluorescein beads.

Mentions: Fluorescent pictures were converted to white and black pictures using image J. Black pixel showed residual fluorescein beads. Figure 4 shows the pixel intensity of residual fluorescein beads for five eyes of each five group. Black pixels were found more in group A than in group B, C, D, or E. The average pixel intensity of fluorescein beads retained inside the capsule in group B, C, D and E was significantly lower than those of Group A (p < 0.001, Turkey-Kramer test) (Figure 5). There were no significant differences in residual fluorescein beads among Group B, Group C, Group D, and Group E.Figure 4


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)

Photograph of fluorescent pixel after removal of the fluorescein bead-labelled OVD in all five eyes of each group (A, B, C, D,and E). Black pixel showing residual fluorescein beads.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig4: Photograph of fluorescent pixel after removal of the fluorescein bead-labelled OVD in all five eyes of each group (A, B, C, D,and E). Black pixel showing residual fluorescein beads.
Mentions: Fluorescent pictures were converted to white and black pictures using image J. Black pixel showed residual fluorescein beads. Figure 4 shows the pixel intensity of residual fluorescein beads for five eyes of each five group. Black pixels were found more in group A than in group B, C, D, or E. The average pixel intensity of fluorescein beads retained inside the capsule in group B, C, D and E was significantly lower than those of Group A (p < 0.001, Turkey-Kramer test) (Figure 5). There were no significant differences in residual fluorescein beads among Group B, Group C, Group D, and Group E.Figure 4

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