Clinical study using a new phacoemulsification system with surgical intraocular pressure control

Solomon, Kerry D.; Lorente, Ramón; Fanney, Doug; Cionni, Robert J.

doi:10.1016/j.jcrs.2016.01.037

Cited by 48 publications

(71 citation statements)

References 15 publications

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“…But it brings the effect of high perfusion pressure at the same time. Previous reports have reported that the instability of the uidics system during cataract surgery results in a longer operation time and an increase in CDE, which in turn will lead to longer recovery time and even poor visual function in postoperative patients [1][2]. So we wonder whether the uctuation of intraocular perfusion pressure during phacoemulsi cation affect fundus microcirculation and then affect the patient's postoperative vision.…”

Section: Discussionmentioning

confidence: 97%

“…Speci c perfusion is necessary to maintain the stability of the anterior chamber during cataract extraction. And this may cause transient intraocular pressure (IOP) uctuations during surgery which consequently result in corneal edema, poor visual acuity and longer time to recovery after surgery [1][2]. Whether the intraoperative perfusion and other surgical factors may cause fundus hemodynamic changes, especially macular microcirculation changes is worth exploring.…”

Section: Introductionmentioning

confidence: 99%

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Optical coherence tomography angiography evaluation of the effects of phacoemulsification cataract surgery on macular hemodynamics in Chinese normal eyes

Jia

Wei

Song³

2020

Preprint

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Background：To quantitatively evaluate the possible effects of phacoemulsification cataract surgery on macular hemodynamics using optical coherence tomography angiography (OCTA).Methods：Prospective observational study. Superficial and deep macular vascular densities as well as parameters of foveal avascular zone (FAZ) were measured preoperatively (baseline) and at 1 day, 1 week and 4 weeks postoperatively in normal eyes (≥22 mm and ≤24 mm) of patients scheduled for phacoemulsification cataract surgery with intraocular lens implantation. Correlations between the rate of change of pre- and post-operative vascular densities and surgical parameters were analyzed.Results: 123 eyes of 107 patients were recruited. Compared with baseline measurements, no statistically significant variation was found in macular vascular densities of 1 day after surgery (P>0.05). While both superficial and deep macular vascular densities were significantly increased postoperatively on week 1 and week 4 (P<0.05; P<0.05). There were no statistically significant differences in any of the FAZ parameters between the baseline measurements and the entire follow-up period (P>0.05 for all). There were no statistically significant correlations between main surgical parameters and the changes of macular vascular densities.Conclusions: In normal eyes, macular blood perfusion gradually increased after phacoemulsification cataract surgery and was stabilized in one week. Foveal avascular zone was basically stable before and after surgery. Main parameters and intraoperative perfusion of phacoemulsification surgery may not be the key factors affecting macular hemodynamics.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography angiography evaluation of the effects of phacoemulsification cataract surgery on macular hemodynamics in Chinese normal eyes

Jia

Wei

Song³

2020

Preprint

View full text Add to dashboard Cite

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“…The new devices with active fluidics, where the height of the irrigation bottle is not crucial, are the hope for the future. Active fluidics limits the need for high intraocular tension, while maintaining stability of the anterior chamber 17,18 . At the same time, it also contributes to improving the resulting parameters of the efficacy of phacoemulsification 19 .…”

Section: And In Cadaver Eyes By Khngmentioning

confidence: 99%

Intraoperative intraocular pressure fluctuation during standard phacoemulsification in real human patients

Hejsek

Kadlecová

Šín

et al. 2019

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Introduction.To evaluate the results of the fluctuations of intraocular pressure (IOP) and calculated mean ocular perfusion pressure (MOPP) during the usual steps of standard phacoemulsification. Methods. Nine human eyes were evaluated. The IOP was measured indirectly by electronic applanation tonometer. The MOPP was calculated using the systolic blood pressure (SBP), the diastolic blood pressure (DBP) and the IOP: MOPP = 2/3x[DBP + 1/3x(SBP -DBP)] -IOP. The operations were performed with the INFINITI ® Vision System: main incision 2.2 mm, coaxial handpiece, 2 paracenteses 1.1 mm, bimanual irrigation/aspiration, bottle height 100 cm. As ocular viscoelastic device (OVD) Hypromel 2.5% (UNIMED) was used. Results. The initial and final IOPs were 17-30 Torr (median 18) and 6-16 Torr (median 8), respectively. The IOP values oscillated between 4 and 63 Torr during the procedure. The highest values of the IOP were achieved at the beginning of phacoemulsification (from 42 to 63 Torr). The maximum pressure higher than 50 mmHg and 60 mmHg was found in 89% and 30% of cases, respectively. The mean ocular perfusion pressure (MOPP) at the beginning of the procedure was 46.4-67.0 (median 53.3) and 0.4-42.0 (median 19.3) during the maximum intraocular pressure. Conclusions. Measured IOP as well as MOPP varied in all normal steps of real phacoemulsification. High values of intraoperative IOL induced by irrigation may compromise the intraocular perfusion. These fluctuations may induce impairment of the optic nerve perfusion, as well as retina, or choroid.

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“…der kumulativen Energie. Der geringere Flüssigkeitsverbrauch soll auch das Endothel schützen [3,4]. Beim Ver- gleich der unterschiedlichen Phakohandgriffspitzen Kelman Tipp und Balanced Tipp konnte bei der mikrokoaxialen torsionalen Phakoemulsifikation kein Unterschied im Endothelzellverlust gezeigt werden [15], jedoch wurde die gleiche Flüssigkeitssteuerung verwendet und nicht auf den Unterschied der aktiven und der standardisierten Flüssigkeitssteuerung eingegangen.…”

Section: Diskussionunclassified

Effektivität und Sicherheit eines modifizierten Tipdesigns bei der torsionalen Phakoemulsifikation

Schmidt¹,

Hubich²,

Vetter³

et al. 2018

Klin Monatsbl Augenheilkd

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Compared to torsional phacoemulsification with a mini-flared Kelman Tip and gravity fluidics, torsional phacoemulsification with a modified tip design and active fluidics is 38% more effective regarding the cumulative dissipated energy. Endothelial cell loss occurs to a similar extend using both systems. The postoperative changes in cell size (polymegathism), number of hexagonal cells (pleomorphism) and corneal thickness (pachymetry) were similar among both systems. We conclude, that the intraoperative stress on the endothelium is equivalent with both systems used.

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Clinical study using a new phacoemulsification system with surgical intraocular pressure control

Abstract: Drs. Solomon and Cionni are consultants to Alcon Research, Ltd., and received compensation for conduct of the study. Dr. Lorente received compensation for clinical work in the study. Mr. Fanney is an employee of Alcon Research, Ltd.

Cited by 48 publications

References 15 publications

Optical coherence tomography angiography evaluation of the effects of phacoemulsification cataract surgery on macular hemodynamics in Chinese normal eyes

Optical coherence tomography angiography evaluation of the effects of phacoemulsification cataract surgery on macular hemodynamics in Chinese normal eyes

Intraoperative intraocular pressure fluctuation during standard phacoemulsification in real human patients

Effektivität und Sicherheit eines modifizierten Tipdesigns bei der torsionalen Phakoemulsifikation

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