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

Abstract

BackgroundTo determine if a method for irrigation and aspiration (I/A) during cataract surgery provides effective removal of ophthalmic viscoelastic device (OVD).MethodsJapanese 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.ResultsTechnique 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).ConclusionsTechnique 2 proved to remove more effectively fluorescein bead-labelled OVD under the IOL than Technique 1.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2415-14-129) contains supplementary material, which is available to authorized users.

Ophthalmic viscosurgical device interaction with two hydrophobic acrylic intraocular lenses of different equilibrium water content

“…Despite the protective role OVDs play during lens removal and IOL implantation, they may contribute to increased postoperative IOP in the anterior chamber if they are not entirely removed after the implantation procedure 1 , 2 , 4 , 14 . Increased IOP can damage the corneal endothelial cells, and in some cases may damage the optic nerve 15 . The time required for complete OVD removal may be correlated to endothelial cell loss 4 .…”

Scleral Buckling with Viscoelastics or Gas Injection for Bulging Retinal Detachments: A Retrospective Cohort Study

“…Viscoelastic agents are commonly used as auxiliary materials in clinical ophthalmic surgery, including cataract and vitreous surgery [10][11][12]. e density and refractive index of a viscoelastic agent is close to those of the vitreous body [10][11][12], which allows a more precise observation of the subsequent hole positioning and condensation treatment after viscoelastic agent injection into the vitreous cavity. In addition, viscoelastic agents can liquefy and are gradually absorbed as the vitreous regenerates, and do not stay long in the eye [10,[21][22][23].…”

“…Viscoelastic agents are commonly used as auxiliary materials in ophthalmic surgery, especially cataract and vitreous surgery [10][11][12]. Comparing phacoemulsification surgery (PE) with viscosurgical devices (OVDs) and without OVD, best-corrected visual acuity (BCVA) values were significantly different on the day following surgery (0.41 ± 0.26 and 0.54 ± 0.34 logMAR) in OVD and non-OVD groups, respectively, although both groups had similar values at 6 months postoperatively [12].…”

Evaluation of two techniques for irrigation/aspiration retrolental viscoelastic removal in cataract surgery

“…Despite OVD aspiration only from the middle of the AC with no manipulation of the IOL, it is known to be ineffective to achieve complete evacuation [14], authors have not agreed yet on the gold standard technique for this step of the surgery.…”