Efficacy of Ophthalmic Viscosurgical Devices in Preventing Temperature Rise at the Corneal Endothelium during Phacoemulsification

Suzuki, Hajime; Igarashi, Tsutomu; Shiwa, Toshihiko; Takahashi, Hiroshi

doi:10.3109/02713683.2015.1136420

Cited by 20 publications

(17 citation statements)

References 23 publications

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“…DMEK) or even penetrating keratoplasty (Dick et al 1996;D ıaz-Valle et al 1998;Walkow et al 2000;Morikubo et al 2004;Storr-Paulsen et al 2008;Gonen et al 2012;Keenan et al 2012;Shimazaki et al 2014). Numerous studies investigated factors with an impact on the corneal endothelium during cataract surgery, such as ultrasound time and energy, temperature increase, nuclear fragments colliding with the corneal endothelium, firmness of the lens, turbulent flow during irrigation, fluctuating or increased intraocular pressure due to the bottle height of the irrigation solution, surgical instruments and techniques, as well as the formation of free radicals and the use of ophthalmic viscoelastic devices (OVDs) (Svensson & Mellerio 1994;Dick et al 1996;Hayashi et al 1996;Pirazzoli et al 1996;Cameron et al 2001;Miyata et al 2002;Takahashi et al 2002Takahashi et al , 2006Bourne et al 2004;Storr-Paulsen et al 2007Murano et al 2008;Suzuki et al 2009Suzuki et al , 2014Suzuki et al , 2016Ho & Afshari 2015).…”

Section: Introductionmentioning

confidence: 99%

Effects of ultrasound energy on the porcine corneal endothelium – Establishment of a phacoemulsification damage model

Kunzmann

Wenzel

Bartz‐Schmidt

et al. 2019

Acta Ophthalmologica

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Purpose The purpose of this study was to establish a standardized in vitro phacoemulsification damage model for future investigations of the effects of phacoemulsification, surgical devices, protective ophthalmic viscoelastic devices (OVDs), irrigation solutions and other aspects related to cataract phacoemulsification surgery on the corneal endothelium using porcine eyes. Methods Thirty‐four porcine eyes were randomly assigned to three groups (phacoemulsification (n = 13), irrigation (n = 9), control (n = 12)). A total of 5 min of ultrasound energy with intermittent irrigation/aspiration was applied in the eyes of the phacoemulsification group. The eyes of the irrigation group received the identical treatment, but without the application of ultrasound energy. The control group was left untreated. All eyes were then prepared to split corneal buttons followed by 15 days of cultivation. Endothelial cell density (ECD) was assessed blinded on day 15. Results Endothelial cell density declined significantly more until day 15 in the phacoemulsification group (2567 ± 317/267 cells/mm² (median ± 25%/75%‐quartiles), −32.5 ± 7.0/6.4%) compared to the irrigation (3450 ± 350/383 cells/mm², −11.8 ± 5.3/2.6%; p < 0.001) and the control group (3650 ± 288/258 cells/mm², −10.2 ± 3.2/4.6%; p < 0.001). Conclusion The phacoemulsification damage model presented in this study is sensitive to phacoemulsification energy and may reliably be used to investigate various factors involved in phacoemulsification with regard to their influence on corneal endothelial cells. This method is able to replace animal experiments or in vitro cell culture experiments that often do not translate well to the in vivo situation in humans.

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Section: Introductionmentioning

confidence: 99%

Effects of ultrasound energy on the porcine corneal endothelium – Establishment of a phacoemulsification damage model

Kunzmann

Wenzel

Bartz‐Schmidt

et al. 2019

Acta Ophthalmologica

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“…In the future, the safety of this method will be further investigated. Other than maintaining the stability of the anterior chamber, one of the main aspects of OVD use was the protection of intraocular structures such as corneal endothelial cells in intraocular surgery [20,33] or clear crystalline lens in ICL implantation. Given the inhibition of in vivo mitosis in humans, the issue regarding the protection of corneal endothelial cells is critical [34].…”

Section: Discussionmentioning

confidence: 99%

A novel ophthalmic viscosurgical device-free phakic intraocular lens implantation makes myopic surgery safer

Pan

Wen

et al. 2020

Eye and Vis

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Purpose: To assess the efficacy and safety of a novel ophthalmic viscosurgical device-free (OVD-free) method for posterior chamber phakic intraocular lens (PIOL) implantation in myopic eyes. Methods: In this retrospective cohort study, the medical records of myopic eyes that underwent PIOL (Implantable Collamer Lens, ICL) implantation for myopia correction at the Eye Hospital of Wenzhou Medical University between May 2015 and March 2017 were reviewed. A total of 49 eyes with complete data that met follow up requirements (2 h, 1 day, 1 week, 3 months postoperatively) were recruited. Based on the surgical techniques used, the eyes were divided into the OVD-free method group and the standard method group. The clinical data, including intraocular pressure (IOP), corrected distance visual acuity (CDVA) and spherical equivalent (SE), at each follow-up were collected for comparison. Endothelial cell loss and complications were also investigated. Results: Twenty-one eyes received the standard method, and 28 eyes received the OVD-free method. A rise in IOP > 22 mmHg at 2 h was noted in 14 eyes (66.7%) in the standard group and none (0%) in the OVD-free group (p < 0.001). The rise in IOP from baseline was significantly higher at 2 h in the standard group (10.5 ± 5.2 mmHg vs. 2.2 ± 3.3 mmHg, difference: 8.3, 95% CI 5.8 to 10.8; p < 0.001). There was a significant difference in the time course of LogMAR CDVA changes between the two groups (p = 0.047). The LogMAR CDVA was significantly better in the OVD-free method group compared to the standard group at 1 day (− 0.076, 95% CI − 0.134 to − 0.018; p = 0.012), 1 week (− 0.071, 95% CI − 0.135 to − 0.007; p = 0.03), but not at 3 months (− 0.046, 95% CI − 0.107 to 0.015; p = 0.134). There was no significant difference in the time course of SE changes between the two groups (p = 0.471; p = 0.705). In the OVD-free group, mean endothelial cell loss was 4.6% at 3 months (2522 ± 281 vs. 2407 ± 226 cells/ mm 2 , difference:-115, 95% CI − 295 to 65; p = 0.187). No complications were reported in both groups except for the early IOP elevation in the standard group during the observation period. Conclusions: The OVD-free method is safe and efficient for ICL implantation. It can be a safer method of ICL implantation compared to the standard method in that it completely eliminates ophthalmic viscoelastic devicesrelated complications without causing additional complications.

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“…El mecanismo por el que las células endoteliales mueren tras una intervención es múltiple 13,14 . El contacto directo con el terminal de facoemulsificación es excepcional y suele ser derivado de una cirugía complicada.…”

Section: A2 Justificaciónunclassified

“…Sin embargo, la causa más común de perdida endotelial es la cirugía intraocular y, entre ellas, la más frecuente es la facoemulsificación del cristalino 3,5,9,10 . La protección de las CEC durante la cirugía es vital para minimizar el daño 13,14,16 .…”

Section: Cirugía Y Endoteliounclassified

“…Algunos de los factores que van a inducir ese daño, pueden intentar reducirse para minimizar la muerte endotelial, como la disminución del tiempo quirúrgico, de la energía empleada e incluso la utilización de energía torsional en vez de longitudinal 3,5,9,10,115 . Otros factores, como la experiencia del cirujano, condicionan un mejor pronóstico endotelial, debido al bajo número de complicaciones intraoperatorias y la rapidez de la intervención 13,14 .…”

Section: B5 Facoemulsificaciónunclassified

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Efecto de la dexametasona tópica preoperatoria en el endotelio corneal y en biomarcadores inflamatorios de cámara anterior en la cirugía de la catarata del paciente diabético

Ruiz¹

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Efficacy of Ophthalmic Viscosurgical Devices in Preventing Temperature Rise at the Corneal Endothelium during Phacoemulsification

Abstract: Surgeons need to be especially aware of ophthalmic viscosurgical device retention during phacoemulsification, because it can protect the corneal endothelium from heat generated during this procedure.

Cited by 20 publications

References 23 publications

Effects of ultrasound energy on the porcine corneal endothelium – Establishment of a phacoemulsification damage model

Effects of ultrasound energy on the porcine corneal endothelium – Establishment of a phacoemulsification damage model

A novel ophthalmic viscosurgical device-free phakic intraocular lens implantation makes myopic surgery safer

Efecto de la dexametasona tópica preoperatoria en el endotelio corneal y en biomarcadores inflamatorios de cámara anterior en la cirugía de la catarata del paciente diabético

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