First Author: M.Kasaoka JAPAN
Co Author(s): T. Urano R. Yamakawa
Purpose:
We developed a disposable lid speculum with a drape (LiDrape ® HAKKO CO, LTD, Nagano, Japan) and reported at ESCRS 2008-2011 that this device provided a sufficient surgical field and prevented intraoperative bacterial contamination of surgical field. The LiDrape ® is a cylindrical device consisting of 2 rings, an upper (58 mm) and a lower (five sizes: 24, 25, 26, 27, and 28 mm) rings made of thermoplastic resin, and a transparent elastic silicone membrane attached to the rings. The eyelids are sandwiched between the upper and the lower rings, and a hole in the center provides a surgical field. The eyelids are kept open by the tension of the elastic silicone membrane of the device, and eyelid margins (eyelashes, eyelids, meibomian glands) are physically isolated from the surgical field by the membrane. We examined whether the tension of the speculum has the effect on intraocular pressure (IOP).
Setting:
Department of Ophthalmology, Kurume University Hospital, Fukuoka, Japan.
Methods:
IOP was measured in 30 eyes of 26 consecutive patients (mean age 67.4 ± 15.3 years) who underwent ophthalmic surgery at Kurume University Hospital. The LiDrape?® was used in cataract surgery (19 eyes), glaucoma surgery (3 eyes), vitrectomy (4 eyes), and intravitreal injection (4 eyes). The lower ring size (less than 27 mm vs greater than or equal 27 mm) was 16 eyes vs 14 eyes. All measurements were performed in the supine position using the Tono-Pen tonometer (Mentor Ophthalmics, Norwell, Massachusetts, USA) before and after the LiDrape ® placement. Each measurement was performed three times, and the mean value was used for statistical analysis to eliminate artifactual elevation of IOP. The data were analyzed using Wilcoxon signed-rank test. All patients gave informed consent.
Results:
Mean IOP before the LiDrape ® placement was 20.9 mmHg. Mean IOP after the LiDrape ® placement was 22.4 mmHg. There was no statistically significant difference in IOP before and after the LiDrape ® placement for each eye. Mean IOP in cataract surgery (before placement vs after placement) was 19.2 mmHg vs 21.6 mmHg. Mean IOP in glaucoma surgery was 23.4 mmHg vs 25.6 mmHg. Mean IOP in vitrectomy was 18.4 mmHg vs 18.3 mmHg. Mean IOP in intravitreal injection was 29.5 mmHg vs 28.4 mmHg. There was no statistically significant difference in IOP before and after the LiDrape ® placement for each type of surgery. Mean IOP in less than 27 mm lower ring size (before placement vs after placement) was 21.3 mmHg vs 21.5 mmHg. Mean IOP in greater than or equal 27 mm lower ring size was 20.4 mmHg vs 23.5 mmHg. There was no statistically significant difference in IOP before and after the LiDrape ® placement for each size of lower ring.
Conclusions:
It was reported that a conventional lid speculum has the possibility of increasing IOP. But the LiDrape ® had no effect of increasing IOP and may be a safer device for ocular surgery. FINANCIAL DISCLOSURE?: No
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