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Ungricht EL, Harris JT, Jensen NR, Barlow WR, Murri MS, Olson RJ, Pettey JH. Effect of low and passive flow on OVD thermal properties during phacoemulsification. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:507-512. [PMID: 35868436 DOI: 10.1016/j.jcjo.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/03/2022] [Accepted: 06/23/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study the thermal properties and response magnitude of a forced-infusion phacoemulsification machine on 4 ophthalmic viscosurgical devices (OVDs). DESIGN Experimental study. METHODS A phacoemulsification tip, thermocouple, and gauge were placed into an artificial anterior chamber with balanced saline solution (BSS) or approximately 0.1 mL of OVD. Once the thermocouple measured a consistent temperature, the pedal was engaged for 60 seconds; then the tip was removed. The machine was cooled for 5 minutes and flushed with BSS to return to baseline. This was repeated 10 times for each OVD. The research consisted of 2 scenarios: vacuum-blocked flow rate and low aspiration flow rate. RESULTS All OVDs showed greater temperature changes than BSS. In the vacuum-blocked scenario, these increases were statistically significant. The medium viscosity dispersive OVD (DiscoVisc) reached temperatures exceeding 60°C. In the low-flow scenario, HEALON5 and DisCoVisc were significantly different at 5 seconds and only HEALON5 at 10 seconds. No temperature increases over BSS were greater than 1.0°C. CONCLUSIONS The dispersive, cohesive, and viscoadaptive OVDs demonstrated higher temperature changes than BSS but did not reach the threshold for corneal incision contracture. The study team verified the need for at least a minimal flow rate before ultrasound, which is especially evident in the first 10 seconds, because a flow rate of only 20 mL/minute mitigated OVD-related thermal effects. Understanding thermal responses enables corneal incision contracture risk reduction.
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Affiliation(s)
- Emilie L Ungricht
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT; University of Utah School of Medicine, Salt Lake City, UT
| | - Jacob T Harris
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT; University of Utah School of Medicine, Salt Lake City, UT
| | - Nathan R Jensen
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT; University of Utah School of Medicine, Salt Lake City, UT
| | - William R Barlow
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT
| | - Michael S Murri
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT
| | - Randall J Olson
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT
| | - Jeff H Pettey
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT.
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Minami K, Yaguchi S, Bissen-Miyajima H. Temperature-controlled porcine eye holder for observing intraocular temperature during cataract surgery. Sci Rep 2023; 13:4331. [PMID: 36922583 PMCID: PMC10017689 DOI: 10.1038/s41598-023-31070-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/06/2023] [Indexed: 03/17/2023] Open
Abstract
During cataract surgery, the intraocular temperature changes when irrigating low-temperature fluid and ophthalmic viscosurgical devices (OVDs) are inserted in the anterior chamber, and such a temperature variation affects the unfolding of the intraocular lens (IOL). A porcine eye holder was developed for simulating temperature conditions in clinical surgery by maintaining the ocular temperature close to the body temperature. An aluminum holder was designed to fit porcine eyes and maintain the ocular temperature at approximately 36 °C, while surgery was performed at a room temperature of 20 °C. Intraocular temperature was monitored using a thermocouple sensor placed close to the posterior capsule in the vitreous cavity. Temperatures and microscopic image of the anterior chamber were simultaneously recorded. With the use of the eye holder system, the intraocular temperature unstable during surgery was observed, and there were significant reductions during hydrodissection, irrigation and aspiration, OVD insertion in the capsule, and OVD removal after IOL implantation.
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Affiliation(s)
- Keiichiro Minami
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan.
| | - Saori Yaguchi
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Hiroko Bissen-Miyajima
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
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Eom Y, Lee YJ, Song JS, Kim HM, Nam DH. Effect of surgical microscope and illuminated chopper on anterior chamber temperature. BMC Ophthalmol 2023; 23:29. [PMID: 36690966 PMCID: PMC9869552 DOI: 10.1186/s12886-023-02784-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/16/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND To evaluate the effect of the light intensity of the surgical microscope and illuminated chopper on the anterior chamber temperature. STUDY DESIGN Experimental study. METHODS A model eye (Kitaro WetLab System; FCI Ophthalmics, Pembroke, MA, USA) was used in this experimental study. The illuminance of a surgical microscope (Leica M300; Leica Microsystems, Wetzlar, Germany) and illuminated chopper (iChopper NAM-25 GB; Oculight, Korea) with a light source (iVision; Oculight) was measured using an illuminometer. In addition, the temperature in the anterior chamber of the model eye filled with balanced salt solution when using the surgical microscope with a light intensity from level 1 to level 6 and the illuminated chopper at 99% light intensity was measured for 10 min. RESULTS The anterior chamber temperature was increased by 0.2, 0.5, 1.0, and 1.4 ℃ when using the surgical microscope at level 3 (10050 lux), 4 (16490 lux), 5 (24900 lux), and 6 (32500 lux), respectively, for 10 min. The illuminated chopper at 99% light intensity (14893 lux) positioned in the anterior chamber increased the anterior chamber temperature by 0.2° C after 10 min, which was equal to the increase in the temperature caused by the surgical microscope at level 3. CONCLUSION The photothermal effect of the illuminated chopper directly positioned in the anterior chamber appeared to be similar to that of a microscope with similar illuminance. Therefore, the illuminated chopper is safe in terms of anterior chamber temperature changes in cataract surgery.
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Affiliation(s)
- Youngsub Eom
- grid.222754.40000 0001 0840 2678Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-Ro, Danwon-Gu, Ansan-Si, Gyeonggi-Do 15355 Republic of Korea ,grid.222754.40000 0001 0840 2678Department of Ophthalmology, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea ,grid.189967.80000 0001 0941 6502Department of Ophthalmology, Emory University School of Medicine, Emory Clinic Building B, 1365B Clifton Road, Atlanta, GA 30322 USA
| | - Young Joo Lee
- grid.222754.40000 0001 0840 2678Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-Ro, Danwon-Gu, Ansan-Si, Gyeonggi-Do 15355 Republic of Korea ,grid.222754.40000 0001 0840 2678Department of Ophthalmology, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea
| | - Jong Suk Song
- grid.222754.40000 0001 0840 2678Department of Ophthalmology, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea
| | - Hyo Myung Kim
- grid.222754.40000 0001 0840 2678Department of Ophthalmology, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea
| | - Dong Heun Nam
- grid.411652.5Department of Ophthalmology, Gil Medical Center, College of Medicine, Gachon University Gil Hospital, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, 21565 Republic of Korea
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Lee YK, Chen SH, Hung JH. Eyelid and scleral thermal injury following phacoemulsification in silicone oil: a case report. BMC Ophthalmol 2022; 22:420. [DOI: 10.1186/s12886-022-02646-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Phacoemulsification has been the mainstay method for extracapsular cataract extraction surgery in the anterior segment; for cases of posterior drop of lens fragments into the vitreous, a posterior segment phacoemulsification instrument (fragmatome; Alcon, Inc., Fort Worth, TX) can be employed to remove the dislocated lens materials. Studies have reported on thermal injury to the cornea during phacmoemulsification of the anterior segment. However, few studies have investigated thermal burn in the simultaneous sclera and eyelid induced by the fragmatome. Currently, there is no reports and lack of optimal strategy for the management of nucleus drop in a vitreous cavity filled with silicon oil.
Case Presentation
We present the case of a 53-year-old male patient with a thermal burn wound on the upper eyelid and sclera following phacoemulsification for a dropped lens in a silicone oil-filled vitreous. We further designed an experiment to verify our hypothesis that thermal injury could be induced by the high temperature of the metal tip during phacoemulsification in silicone oil. In our experiment, during 420 s of continuous ultrasonic wave, the temperature of the fragmatome tip in the balanced salt solution (BSS) increased from 22.0 to 24.0 ºC, while the temperature of the fragmatome tip in the silicone oil group increased from 22.0 to 43.0 ºC.
Conclusions
The temperature of the fragmatome tip increased significantly in silicone oil compared to BSS in the experiment. Thus, physicians should be aware of possible thermal complications when using fragmatome in eyes filled with silicone oil.
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Diseases of the corneal endothelium. Exp Eye Res 2021; 205:108495. [PMID: 33596440 DOI: 10.1016/j.exer.2021.108495] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 12/17/2022]
Abstract
The corneal endothelial monolayer and associated Descemet's membrane (DM) complex is a unique structure that plays an essential role in corneal function. Endothelial cells are neural crest derived cells that rest on a special extracellular matrix and play a major role in maintaining stromal hydration within a narrow physiologic range necessary for clear vision. A number of diseases affect the endothelial cells and DM complex and can impair corneal function and vision. This review addresses different human corneal endothelial diseases characterized by loss of endothelial function including: Fuchs endothelial corneal dystrophy (FECD), posterior polymorphous corneal dystrophy (PPCD), congenital hereditary endothelial dystrophy (CHED), bullous keratopathy, iridocorneal endothelial (ICE) syndrome, post-traumatic fibrous downgrowth, glaucoma and diabetes mellitus.
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Kunzmann BC, Wenzel DA, Bartz‐Schmidt KU, Spitzer MS, Schultheiss M. Effects of ultrasound energy on the porcine corneal endothelium - Establishment of a phacoemulsification damage model. Acta Ophthalmol 2020; 98:e155-e160. [PMID: 31469490 DOI: 10.1111/aos.14235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 08/07/2019] [Indexed: 11/26/2022]
Abstract
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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Affiliation(s)
- Berenike C. Kunzmann
- University Eye Hospital Centre for Ophthalmology University Hospital Tübingen Tübingen Germany
| | - Daniel A. Wenzel
- Department of Ophthalmology University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - Karl U. Bartz‐Schmidt
- University Eye Hospital Centre for Ophthalmology University Hospital Tübingen Tübingen Germany
| | - Martin S. Spitzer
- Department of Ophthalmology University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - Maximilian Schultheiss
- Department of Ophthalmology University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
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Igarashi T, Ohsawa I, Kobayashi M, Umemoto Y, Arima T, Suzuki H, Igarashi T, Otsuka T, Takahashi H. Effects of Hydrogen in Prevention of Corneal Endothelial Damage During Phacoemulsification: A Prospective Randomized Clinical Trial. Am J Ophthalmol 2019; 207:10-17. [PMID: 31077667 DOI: 10.1016/j.ajo.2019.04.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/26/2019] [Accepted: 04/28/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Hydrogen (H2) has been reported to scavenge free radicals, particularly the hydroxyl radical (·OH). Ultrasound oscillation in an aqueous solution produces ·OH. Our recent study demonstrated that H2 dissolved in an irrigation solution prevented corneal endothelial damage during phacoemulsification in an animal model. We examined the effects of H2 during clinical phacoemulsification. DESIGN A single-center, prospective, randomized, double-masked clinical trial. METHODS Thirty-two patients who had cataracts of similar nucleus hardness in both eyes (age: 75.4±7.68 years; 17 males, 15 females) were recruited. Phacoemulsification was performed using a solution of dissolved H2 in one eye, and a conventional solution in the contralateral eye. Endothelial cell density (ECD) at the center of the cornea was measured using noncontact specular microscopy preoperatively and at 1 day, 1 week, and 3 weeks postoperatively. RESULTS Reduction rates of ECD (mean ± standard deviation) were 16.0%±15.7% at 1 day, 15.4%±16.1% at 1 week, and 18.4%±14.9% at 3 weeks in the control group, compared to 6.5%±8.7% at 1 day (P = .003), 9.3%±11.0% at 1 week (P = .039), and 8.5%±10.5% at 3 weeks (P = .004) in the H2 groups. These rates were significantly smaller in the H2 group at all time points. CONCLUSIONS H2 dissolved in irrigation solution reduced corneal endothelial damage during phacoemulsification. This suggests that a considerable part of the corneal endothelial damage during phacoemulsification is caused by oxidative stress, and that H2 is useful in clinical phacoemulsification.
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Abstract
PURPOSE To study a prototype of an ultrasound-based vitrector, and to try to understand the physical phenomena underlying this new technology. METHODS We tested the ultrasound-based vitrector prototype (UV) (ultrasonically-driven handpiece obtained from a modified version of the Alcon CONSTELLATION Vision System [Alcon]) using an automatic experimental setup. Balanced saline solution (BSS) and vitreous (from fresh postmortem enucleated porcine eyes) flow rates were analyzed using three different tips. RESULTS In general, BSS solution flow rates increased with increasing aspiration levels and decreased when we used % US power. Vitreous flow rates were influenced by aspiration levels, % US power, and ultrasound-related phenomena: cavitation phenomenon and "jet streaming." CONCLUSION Ultrasound-based vitrectomy may represent an important alternative to traditional vitrectomy. Such a tool, capable of liquefying and excising the vitreous body using ultrasound, could overcome all the limits of the guillotine-based technique (GV). Knowledge of the physical phenomena underlying ultrasound-based technology is a necessary prerequisite for further development of this new technology.
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Suzuki H, Igarashi T, Shiwa T, Takahashi H. A Novel "Slit Side View" Method to Evaluate Fluid Dynamics during Phacoemulsification. J Ophthalmol 2018; 2018:5027238. [PMID: 30363725 PMCID: PMC6180966 DOI: 10.1155/2018/5027238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 08/08/2018] [Indexed: 11/18/2022] Open
Abstract
Due to recent technical advances in cataract surgeries, there has been a significant improvement in the safety and surgical outcomes of phacoemulsification. However, the corneal endothelium can be damaged during phacoemulsification by multiple factors. Therefore, we used a slit lamp to analyze the fluid dynamics of ophthalmic viscosurgical devices (OVDs) in the anterior chamber during phacoemulsification. In this experimental study, extracted porcine eyes were injected with OVDs stained with fluorescein through a side port of the eye and then fixed on a slit lamp microscope. After inserting a phaco tip, phacoemulsification simulation was then performed on the iris plane. Subsequent movements of OVDs in the anterior chamber were observed during the procedure by using a slit lamp microscope. Aspiration and removal of cohesive OVDs from the inside of the anterior chamber occurred within a few seconds after the ultrasonic vibration. Aspiration of dispersive OVDs occurred gradually, with some of the OVDs remaining on the side of the anterior chamber side in an irregular shape. This shape enabled the OVD to trap the air, thereby preventing the air from directly touching the corneal endothelium. Viscoadaptive OVDs remained inside the anterior chamber as a lump, with the infusion solution flowing between the corneal endothelium and the OVD, thus leading to the eventual aspiration of the OVD. Viscous dispersive OVDs remained as a lump between the corneal endothelium and the phaco tip. However, once the infusion solution flowed between the cornea and the OVD, the OVD detached from the corneal endothelium, indicating that this type would likely be aspirated and removed. This method, termed the "slit side view," enables viewing of the movement of OVDs during surgery, as well as observation of the fluid dynamics in the anterior chamber.
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Affiliation(s)
- Hisaharu Suzuki
- Department of Ophthalmology, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki City, Kanagawa 211-8533, Japan
| | - Tsutomu Igarashi
- Department of Ophthalmology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - Toshihiko Shiwa
- Department of Ophthalmology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - Hiroshi Takahashi
- Department of Ophthalmology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
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Igarashi T, Ohsawa I, Kobayashi M, Igarashi T, Suzuki H, Iketani M, Takahashi H. Hydrogen prevents corneal endothelial damage in phacoemulsification cataract surgery. Sci Rep 2016; 6:31190. [PMID: 27498755 PMCID: PMC4976317 DOI: 10.1038/srep31190] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 07/13/2016] [Indexed: 01/26/2023] Open
Abstract
In phacoemulsification, ultrasound induces hydroxyl radical (·OH) formation, damaging corneal endothelium. Whether H2 can prevent such oxidative damage in phacoemulsification was examined by in vitro and in vivo studies. H2 was dissolved in a commercial irrigating solution. The effects of H2 against ·OH generation were first confirmed in vitro by electron-spin resonance (ESR) and hydroxyphenyl fluorescein (HPF). ESR showed a significantly decreased signal magnitude, and fluorescence intensity by oxidized HPF was significantly less in the H2-dissolved solution. The effects of H2 in phacoemulsification were evaluated in rabbits, comparing H2-dissolved and control solutions. Five hours after the procedure, the whole cornea was excised and subjected to image analysis for corneal edema, real-time semiquantitative PCR (qPCR) for heme oxygenase (HO)-1, catalase (CAT), superoxide dismutase 1 (SOD1), and SOD2 mRNA, and immunohistochemistry. Corneal edema was significantly less and the increases in anti-oxidative HO-1, CAT and SOD2 mRNA expressions were significantly suppressed in the H2 group. In addition, corneal endothelial cell expressions of two oxidative stress markers, 4-HNE and 8-OHdG, were significantly lower in the H2 group. In conclusion, H2 dissolved in the ocular irrigating solution protected corneal endothelial cells from phacoemulsification-induced oxidative stress and damage.
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Affiliation(s)
- Tsutomu Igarashi
- Department of Ophthalmology, Nippon Medical School 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
| | - Ikuroh Ohsawa
- Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015 Japan
| | - Maika Kobayashi
- Department of Ophthalmology, Nippon Medical School 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
| | - Toru Igarashi
- Department of Pediatrics, Nippon Medical School 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
| | - Hisaharu Suzuki
- Department of Ophthalmology, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki City, Kanagawa 211-8533, Japan
| | - Masumi Iketani
- Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015 Japan
| | - Hiroshi Takahashi
- Department of Ophthalmology, Nippon Medical School 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
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Suzuki H, Igarashi T, Shiwa T, Takahashi H. Efficacy of Ophthalmic Viscosurgical Devices in Preventing Temperature Rise at the Corneal Endothelium during Phacoemulsification. Curr Eye Res 2016; 41:1548-1552. [DOI: 10.3109/02713683.2015.1136420] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hisaharu Suzuki
- Department of Ophthalmology, Nippon Medical School Musashikosugi Hospital, Nakahara-ku, Kawasaki City, Kanagawa, Japan
| | - Tsutomu Igarashi
- Department of Ophthalmology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Toshihiko Shiwa
- Department of Ophthalmology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Takahashi
- Department of Ophthalmology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
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Rossi M, Di Censo F, Di Censo M, Oum MA. Changes in Aqueous Humor pH After Femtosecond Laser-Assisted Cataract Surgery. J Refract Surg 2015; 31:462-5. [PMID: 26158926 DOI: 10.3928/1081597x-20150623-04] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 05/12/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare aqueous humor pH values in patients during femtosecond laser-assisted cataract surgery with patients during conventional phacoemulsification. METHODS A prospective clinical study was conducted in 29 eyes of 29 patients who underwent cataract surgery by a single surgeon. The femtosecond laser group included 15 eyes operated on with a femtosecond laser platform (Catalys; Abbott Medical Optics, Santa Ana, CA) and the phacoemulsification group included 14 eyes that were operated on with conventional phacoemulsification. The femtosecond laser group was subdivided into low, medium, and high level of cavitation gas bubbles after docking and the femtosecond laser procedure, according to the judgment of the surgeon. Aqueous humor samples (0.10 to 0.15 mL) were collected through a paracentesis from each patient after docking, corneal incisions, and nucleus fragmentation in the femtosecond laser group and after corneal incisions but before injection of viscoelastic in the phacoemulsification group, then analyzed with a pH meter. RESULTS The mean pH was 6.53 ± 0.09 (range: 6.42 to 6.70) and 7.42 ± 0.07 (range: 7.28 to 7.48) in the femtosecond laser and phacoemulsification groups, respectively (P < .001). In the femtosecond laser group, no significant differences in pH were observed between the three subgroups after docking and the femtosecond laser surgical procedure: low (6.55 ± 0.09 [range: 6.53 to 6.57]), medium (6.54 ± 0.07 [range: 6.52 to 6.55]), and high (6.42 ± 0.00 [range: 6.40 to 6.44]) level of gas bubbles. CONCLUSIONS Cavitation bubbles derived from the photodisruption process in femtosecond laser-assisted cataract surgery lead to an acidic shift of the aqueous humor pH as a result of the transformation of carbon dioxide to carbonic acid. The level of gas bubbles visible after the laser photodisruption does not seem to correlate with this pH shift. Further analysis of femtosecond laser-assisted cataract surgery is necessary.
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