Effect of irrigating solution and irrigation temperature on the cornea and pupil during phacoemulsification

Joussen, Antonia M.; Barth, Ulrike; Çubuk, Hasan; Koch, H.-R.

doi:10.1016/s0886-3350(99)00470-8

Cited by 47 publications

(51 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Due to the development of microsurgical techniques and intraocular lens (IOL), lens removal and posterior chamber IOL implantation are becoming more common [9][10][11][12][13][14]. The corneal endothelium can be damaged in a number of ways, including physical trauma [15,16], IOL contact, corneal toxicity of surgical solutions and drugs [17,18], and free radicals induced by ultrasound oscillation [19,20]. In addition, many studies have reported endothelial cell loss after cataract surgery in adults [15,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up of changes in corneal endothelium after primary and secondary intraocular lens implantations in children

Kim

et al. 2011

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Long-term follow-up of changes in corneal endothelium after primary and secondary intraocular lens implantations in children

Kim

et al. 2011

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

show abstract

“…Numerous studies [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] suggest that other factors may play a significant role in the cellular damage. Studies of the mechanism of aging damage and diabetic effects on corneal endothelial cells show that much of the damage is mediated by free radicals; ie, reactive oxygen species.…”

mentioning

confidence: 99%

“…38 It protects membranes, 39,40 anterior segment tissues from hydrogen peroxide, 13 the lens, 27,39,41 and the corneal endothelium. 21,42 In the present study, we designed an in vivo rabbit model experiment of phacoemulsification in the anterior chamber in which 4 irrigating solutions were applied.…”

mentioning

confidence: 99%

Protective effect of free-radical scavengers on corneal endothelial damage in phacoemulsification

Nemet¹,

Assia²,

Meyerstein³

et al. 2007

Journal of Cataract and Refractive Surgery

View full text Add to dashboard Cite

show abstract

“…The irrigation solution in phacoemulsification surgery plays an important role in maintaining a constant pressure in the anterior chamber, dissipating heat generated from the ultrasonic tip, and helping maintain endothelial cell survival by the chemical composition of the solution (Joussen et al 2000). Despite its importance, several studies have shown that the impinging flow from the irrigation solution on the corneal endothelial cells in the inner eye can damage these cells during the procedure (Polack and Sugar 1976;Binder et al 1976;Miller et al 1996;Hayashi et al 1996;Topaz et al 2002;O'Brien et al 2004;Steinert and Schafer 2006).…”

Section: Introductionmentioning

confidence: 99%

Combined micro and macro additive manufacturing of a swirling flow coaxial phacoemulsifier sleeve with internal micro-vanes

Choi

Yamashita

Sakakibara

et al. 2010

Biomed Microdevices

View full text Add to dashboard Cite

Microstereolithography (microSL) technology can fabricate complex, three-dimensional (3D) microstructures, although microSL has difficulty producing macrostructures with micro-scale features. There are potentially many applications where 3D micro-features can benefit the overall function of the macrostructure. One such application involves a medical device called a coaxial phacoemulsifier where the tip of the phacoemulsifier is inserted into the eye through a relatively small incision and used to break the lens apart while removing the lens pieces and associated fluid from the eye through a small tube. In order to maintain the eye at a constant pressure, the phacoemulsifier also includes an irrigation solution that is injected into the eye during the procedure through a coaxial sleeve. It has been reported, however, that the impinging flow from the irrigation solution on the corneal endothelial cells in the inner eye can damage these cells during the procedure. As a result, a method for reducing the impinging flow velocities and the resulting shear stresses on the endothelial cells during this procedure was explored, including the design and development of a complex, 3D micro-vane within the sleeve. The micro-vane introduces swirl into the irrigation solution, producing a flow with rapidly dissipating flow velocities. Fabrication of the sleeve and fitting could not be accomplished using microSL alone, and thus, a two-part design was accomplished where a sleeve with the micro-vane was fabricated with microSL and a threaded fitting used to attach the sleeve to the phacoemulsifier was fabricated using an Objet Eden 333 rapid prototyping machine. The new combined device was tested within a water container using particle image velocimetry, and the results showed successful swirling flow with an ejection of the irrigation fluid through the micro-vane in three different radial directions corresponding to the three micro-vanes. As expected, the sleeve produced a swirling flow with rapidly dissipating streamwise flow velocities where the maximum measured streamwise flow velocities using the micro-vane were lower than those without the micro-vane by 2 mm from the tip where they remained at approximately 70% of those produced by the conventional sleeve as the flow continued to develop. It is believed that this new device will reduce damage to endothelial cells during cataract surgery and significantly improve patient outcomes from this procedure. This unique application demonstrates the utility of combining microSL with a macro rapid prototyping technology for fabricating a real macro-scale device with functional, 3D micro-scale features that would be difficult and costly to fabricate using alternative manufacturing methods.

show abstract

Effect of irrigating solution and irrigation temperature on the cornea and pupil during phacoemulsification

Abstract: Long-term results were equally favorable in all 4 groups. However BSS Plus induced less short-term corneal swelling than Ringer's solution. From these findings, it appears that BSS Plus may decrease corneal risk in cases with compromised corneas or prolonged surgery.

Cited by 47 publications

References 10 publications

Long-term follow-up of changes in corneal endothelium after primary and secondary intraocular lens implantations in children

Long-term follow-up of changes in corneal endothelium after primary and secondary intraocular lens implantations in children

Protective effect of free-radical scavengers on corneal endothelial damage in phacoemulsification

Combined micro and macro additive manufacturing of a swirling flow coaxial phacoemulsifier sleeve with internal micro-vanes

Contact Info

Product

Resources

About