Effect of air bubble on inflammation after cataract surgery in rabbit eyes

Corneal Effect of Air Bubble After Phacoemulsification

Objectives

The aim of the study was to investigate the effect of air bubble on the cornea at the end of the cataract surgery with phacoemulsification.

Methods

This prospective and case-control study included 71 patients with air bubble injected into the anterior chamber at the end of the operation and 63 age-sex-matched control patients without air bubble. Endothelial cell density (ECD), coefficient of variation (CV), hexagonality rate (HEX), and central corneal thickness (CCT) measurements were taken using non-contact specular microscopy preoperatively and at 1-day, 1-week, and 1-month postoperatively.

Results

No significant difference was determined between the groups preoperatively in respect of mean visual acuity, anterior chamber depth, ECD, CV, HEX, and CCT values (p>0.05). The intraoperative average ultrasound power, effective phaco time, and ultrasound time values were similar (p>0.05). The CCT value was lower in the study group than in the control group on post-operative day 1 (p=0.012), but similar at 1 week and 1 month (p=0.102, p=0.330, respectively). No significant difference was determined between the groups in mean visual acuity, anterior chamber reaction, ECD, CV, and HEX values at 1-day, 1-week, and 1-month postoperatively (p>0.05).

Conclusion

Air bubble may be used as an alternative method to reduce corneal edema on the 1st post-operative day. According to the results, although air bubble has no detrimental effect, there is also seen to be no protective effect on the corneal endothelium.

Trauma-Induced Uveitis and Free Air in the Anterior Chamber of Three Eastern Screech Owls (Megascops asio)

Unusual ocular abnormalities were documented in 3 wild eastern screech owls (Megascops asio) presented to a wildlife rehabilitation hospital after vehicular strike-induced trauma to the head. All 3 had anterior uveitis and free air bubbles in the anterior chamber, but none of the cases had any discernable corneal damage, either grossly or with fluorescein stain technique. Perforation of the globe at the level of the scleral ossicle was considered a possible cause. All 3 cases recovered with standard treatment for anterior uveitis, and the free air was absorbed within 10-14 days and did not appear to cause any lingering complications. The owls were later released back into the wild after demonstrating the ability to navigate obstacles in a flight cage and capture live prey.

Intracameral air injection after completion of phacoemulsification cataract surgery: Evaluation of corneal incisions with optical coherence tomography

Purpose

To evaluate the effects of air bubbles on clear corneal incision (CCI) in patients who had phacoemulsification surgery, and to compare this type of CCI architecture with patients who had no air bubbles after phacoemulsification surgery, using anterior segment optical coherence tomography (AS-OCT).

Methods

Eyes which had undergone uneventful phacoemulsification cataract surgery with implantation of a posterior chamber intraocular lens (IOL) were equally randomized into two groups. Group 1 comprised patients with anterior chamber air bubble injection after phacoemulsification, and Group 2 comprised patients who had undergone phacoemulsification surgery without anterior chamber air bubble. Postoperative evaluation included AS-OCT (Heidelberg Engineering, Germany) and pneumatic tonometry (Nidek NT-1000 Pneumatic Tonometer, Japan) in the 2nd hour, then at 1 week, and 1 month. Astigmatic changes assessed with corneal topography after phacoemulsification cataract surgeries were noted.

Results

Evaluation was made of 40 eyes of 28 patients (10 female, 18 male) as 20 eyes in Group 1 and 20 eyes in Group 2. On the first postoperative day, the endothelial gap rate was 13.3% in Group 1 and 57.1% in Group 2 (P = 0.02), and this continued until the 1-month follow-up examination. The Descemet's membrane detachment (DMD) rate was 0% in Group 1 and 42.8% in Group 2 on postoperative day 1 (P = 0.006), and this continued at the 1-month follow-up examination. At 1 month postoperatively, the rates of optical coherence tomography (OCT) parameters were similar. There were no significant differences between preoperative astigmatism and postoperative astigmatism in the group analyses.

Conclusion

In this study, air bubbles decreased the rate of DMD and of endothelial and epithelial gap during the early postoperative period.

Ciliary sulcus implantation of intraocular lens in manual small incision cataract surgery complicated by large posterior capsule rupture

The present study aimed to evaluate the safety and efficiency of ciliary sulcus implantation of intraocular lens (IOL) in patients that had undergone manual small incision cataract surgery (MSICS) complicated by large posterior capsule rupture (LPCR). A total of 11 eyes taken from 11 patients in Brazzaville, Republic of the Congo, that had experienced LPCR following MSICS were included in the current study. A rigid single-piece IOL (5.5 mm optic, 12.50 mm overall length) was implanted into the ciliary sulcus. Postoperative follow-up assessments evaluated visual acuity, anterior segment biomicroscopy, IOL centration and position, and fundus biomicroscopy. The median follow-up time was 3.7 months (range, 2-6 months). All patients experienced vision improvement: Uncorrected visual acuity 2 months following surgery was 0.3-0.5 in 9 patients and >0.5 in 2 patients. Postoperative complications included pronounced anterior segment inflammation (1 patient), mild corneal endothelium edema (3 patients), residual cortex (1 patient) and intraocular pressure elevation (1 patient). Significant IOL decentration and tilt were not observed in any patients. The results of the present study indicate that ciliary sulcus implantation of a rigid single-piece IOL may be a feasible and effective method of treating patients that have experienced LPCR complications following cataract surgery, as it provides satisfactory visual acuity outcomes. Appropriate intraoperative management may reduce the incidence of postoperative complications.

Management of post-goniopuncture iris herniation: a two-step procedure

A 38-year-old male presented to the emergency room suffering acute pain in his left eye. Two months before he had been submitted to uneventful non-penetrating deep sclerectomy and one month before to YAG-laser goniopuncture. Examination showed iris herniation into the trabeculo-descemet's window. Surgical reduction was carried out through a peripheral corneal incision, and a large air bubble was injected into the anterior chamber. Four days later a wide laser peripheral iridotomy was performed. This technique can transform a non-penetrating technique into a full-trabeculectomy, without reopening the superficial flap.