Impact of swirling lens fragments on the endothelium during phacoemulsification and the benefit of a novel endothelial protection method

Session Details

Session Title: Cataract I
Session Date/Time: Friday 26/02/2016 | 10:30-12:30
Paper Time: 11:24
Venue: MC3 Room
First Author: : S.Amir-Asgari AUSTRIA
Co Author(s): :    N. Hirnschall,   K. Stjepanek   O. Findl,        

Abstract Details

Purpose:

Classification and quantification of swirling lens fragments during phacoemulsification using a continuous intra-operative optical coherence tomography (ReScan700; Carl Zeiss Meditec AG, Germany) and the evaluation of a novel endothelial protection method.

Setting:

Vienna Institute for Ocular Surgery (VIROS), a Karl-Landsteiner institute, Hanusch Hospital, Vienna, Austria

Methods:

Cataract patients scheduled for surgery were included in this prospective study. During surgery, ci-OCT (ReScan700, Carl Zeiss Meditec AG, Germany) recordings were performed to score swirling lens fragments that came into contact with the corneal endothelium. Endothelial cell density was measured pre-operatively and one month post-operatively. In a sub-group of patients, the anterior capsule ‘flap’ from the capsulorhexis was pushed against the endothelium using ophthalmic viscoelastic substance and, hence, used as an endothelial protection shield during phacoemulsification. This technique was performed by G. La Rocca et al.(Italy) and presented at ESCRS (2015) with a protective effect concerning endothelial cell count.

Results:

One-hundred eyes of 100 patients were recruited. Preliminary results show that on average 2.6 swirling fragments hit the endothelium per eye. The loss of endothelial cells was 2.1% (50 cells/mm2, SD: 209 cells/mm2). Protection of the endothelium by using the anterior lens capsule as a protection shield was found to be a feasible method. Further data as well as the success rate of the novel technique will be presented at the meeting.

Conclusions:

Swirling lens fragments are a risk factor for the endothelium. Novel techniques to protect the endothelium are promising, but more data are needed to prove their benefit.

Financial Disclosure:

NONE