Evaluation of a new method of irrigation and aspiration for removal of ophthalmic viscoelastic device during cataract surgery in a porcine model.
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.
Arisa
A
Mitani
Department of Ophthalmology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan. t-suzuki@m.ehime-u.ac.jp.
Takashi
T
Suzuki
Yoshitaka
Y
Tasaka
Takahiro
T
Uda
Yukako
Y
Hiramatsu
Shiro
S
Kawasaki
Yuichi
Y
Ohashi
D000818:Animals; D019923:Capsulorhexis; D004195:Disease Models, Animal; D004322:Drainage / Q000379:methods*; D019793:Fluorescein / Q000378:metabolism; D019654:Lens Implantation, Intraocular; D008863:Microspheres; D018918:Phacoemulsification; D013552:Swine; D007507:Therapeutic Irrigation / Q000379:methods*; D055682:Viscoelastic Substances / Q000378:metabolism*
D055682:Viscoelastic Substances; D019793:Fluorescein