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Sato T, Yasuhara T, Fukumoto M, Mimura M, Kobayashi T, Kida T, Kojima S, Oku H, Ikeda T. Investigation of scleral thermal injuries caused by ultrasonic pars plana phacoemulsification and aspiration using pig eyes. Int Ophthalmol 2018; 39:2015-2021. [PMID: 30353259 DOI: 10.1007/s10792-018-1036-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 10/11/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to investigate the thermal injuries caused by ultrasonic pars plana phacoemulsification and aspiration (PPPEA) using pig eyes. METHOD Using a 20-gauge (G) vitrectomy system (Accurus®, Fragmatome; Alcon Laboratories) in both the 'open-tip' and 'closed-tip' techniques, PPPEA was performed in pig eyes and the subsequent thermal injuries generated around the scleral wound were measured by infrared thermal imaging (thermography). Post surgery, the state of the scleral wound was observed under a microscope, and a tissue slice containing the scleral wound was then prepared and observed under an optical microscope. RESULTS Thermography measurements revealed a slight temperature rise around the scleral wound in the open-tip case, yet a marked temperature rise in the closed-tip case. The scleral wound incision produced by the open tip was linear, while that produced by the closed tip was expanded. Histological examination revealed mild degeneration of the sclera around the wound in the open-tip case, yet marked tissue degeneration by thermal injuries in the closed-tip case. CONCLUSION Our findings showed that in PPPEA, the temperature of the tip of a 20G vitrectomy system rapidly increases due to the closed-tip technique, thus producing obvious thermal damage to the scleral wound. In order to prevent thermal injuries to the scleral wound during PPPEA, it is important to shorten the time of ultrasonic oscillation during surgery as much as possible while the tip is occluded with nuclear fragments.
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Affiliation(s)
- Takaki Sato
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | | | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Takatoshi Kobayashi
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Shota Kojima
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan.
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Abstract
PURPOSE To report a case and technique for the removal of retained lens cortex material in an office-based procedure using a portable battery-powered vitrectomy system. METHODS Case report. RESULTS An 88-year-old man underwent uncomplicated office-based vitrectomy for the removal of retained lens material with good anatomical and visual outcomes. CONCLUSION The authors report a case of the removal of retained cortex material using an office-based vitrector. Clinicians should be aware of this technique for selected patients.
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