Irrigation dynamic pressure-assisted hydrodissection during cataract surgery

Abstract

The irrigation dynamic pressure-assisted hydrodissection technique (irrigation-hydro [iH]) does not require performing manual hydrodissection using a syringe and cannula to achieve cortical-capsular cleavage during cataract surgery. Since the iH technique uses the phaco tip to intentionally vacuum the intraocular fluid in order to induce the irrigation dynamic pressure for cortical-capsular cleavage, there is a reduction in the intraocular pressure (IOP) from the bottle-height-dependent hydrostatic pressure. Thus, since the peak irrigation pressure derived from the phaco tip sleeve will be limited by the height of the irrigation fluid bottle, this is advantageous in helping to avoid excessively high IOP during cortical-capsular hydrodissection. Using this technique, we were able to effectively perform phacoemulsification without complications in 607 of 609 cataract eyes. Our findings show that utilization of the iH technique would be of benefit to patients, as it prevents high-pressure hydrodissection-related complications, such as capsular block syndrome and tears in the anterior hyaloid membrane during cataract surgery.

Multiquadrant versus single quadrant cortical cleaving hydrodissection during phacoemulsification of age related cataract

“…The ingress of fluid in the vitreous cavity and pupil becoming small confirmed the posterior capsular rupture. Some alternatives have been suggested to avoid hydrodissection related complications, like the mechanical cortical cleaving dissection technique for phacoemulsification 11, 14, 15. This technique, however, seems technically more challenging than manual hydrodisection, and might be risky in patients with zonular dehiscence.…”

Minimal water-jet hydrodissection

“…Different techniques have been described in the literature to reduce PCR complications in PE surgery. 10 – 13 Considering that the majority of PCR complications develop in PE and I/A stages, it is thought that MWH, which facilitates these phases and reduces PCR complications, is a simple technique that can be easily learned and applied to any cataract, including pseudoexfoliation cataracts, in which pupil is not too dilated, and phacodonesis (except posterior polar cataract).…”

The safety and efficacy of phaco-sleeve irrigation-assisted hydrodissection during femtosecond laser-assisted cataract surgery

“…The phaco-sleeve irrigation-assisted hydrodissection (iH) technique (a technique that we previously reported as “irrigation dynamic pressure-assisted hydrodissection”) can be used to avoid excessively high intracapsular pressures (ICPs) during cortical–capsular hydrodissection. 9 – 11 The iH technique during FLACS is initially used to groove and split the lens, followed by dislocation and aspiration of the intracapsular gas (degassing). This reduces the intracapsular volume, the front and back of the intracapsular lens can be bypassed prior to performing the hydrodissection, thereby helping to avoid “lens-capsulotomy block” and “irrigation trap” within the intracapsular space ( Figure 2 ).…”