title: Frequency, source, and prevention of cotton fibers in the anterior chamber during cataract surgery.
abstract: OBJECTIVE
  To prospectively evaluate the frequency of fibers in the anterior chamber during and after cataract surgery, their source, and preventive measures.
  
  
  METHODS
  Department of Ophthalmology, Setagaya-Shimoda Hospital, Tokyo, Japan.
  
  
  METHODS
  Slitlamp biomicroscopy was used to examine 422 eyes after cataract surgery for frequency of fibers in the anterior chamber. In another 78 eyes having cataract surgery, fibers in the anterior chamber were removed and compared with fibrous materials used during surgery using microscopic and Raman spectrometric analyses. Dust-generation tests were conducted on the fibrous materials used in surgery. In 337 eyes having cataract surgery, highly dust-generating materials were excluded during surgery and the frequency of fibers in the anterior chamber was determined.
  
  
  RESULTS
  After surgery, fibers were detected in the anterior chamber in 7 (1.7%) of 422 eyes. No inflammation was observed during a 1-year follow-up. During surgery, fibers suspended in the anterior chamber were observed in 5 (6.4%) of 78 eyes. Microscopic and Raman spectrometric analyses showed that the fibers were identical to the cotton fibers in cotton balls and gauze. Cotton balls had the highest dust-generation rate of fibrous materials used intraoperatively. Excluding cotton balls significantly reduced the frequency of fibers to 5 (1.5%) of 337 eyes (P = .0239).
  
  
  CONCLUSIONS
  During routine cataract surgery, fibers were introduced into the anterior chamber in 6.4% of cases. Of the fibrous materials used in surgery, cotton balls generated the most fibers. Eliminating cotton balls alone significantly reduced the frequency of fibers in the anterior chamber to 1.5%.
authors.affiliation: Department of Ophthalmology, School of Medicine, Nihon University, Tokyo, Japan. sshimada@olive.ocn.ne.jp <sshimada@olive.ocn.ne.jp>
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimada
authors.forename: Shinji
authors.initials: S
authors.lastname: Arai
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawamata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakashizuka
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hattori
authors.forename: Mitsuko
authors.initials: M
authors.lastname: Yuzawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology*; D032561:Cotton Fiber; D005129:Eye Foreign Bodies / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008853:Microscopy; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects* / Q000295:instrumentation; D011446:Prospective Studies; D013059:Spectrum Analysis, Raman