Visualization of fluid dynamics under the intraocular lens in irrigation and aspiration

Poster Details

First Author: T.Uda JAPAN

Co Author(s):    A. Mitani   Y. Tasaka   S. Kawasaki   T. Suzuki   Y. Ohashi  

Abstract Details

Purpose:

Residual ophthalmic viscosurgical device (OVD) under the intraocular lens (IOL) seems to be one risk factor of high intraocular pressure or endophthalmitis after cataract surgery. Thus removing OVD from under the IOL is a critical process. However, little is known about the fluid dynamics of irrigation solution under the IOL. This study was designed to investigate techniques for visualizing irrigation solution under the IOL.

Setting:

Department of Ophthalmology, Ehime University School of Medicine

Methods:

The Miyake-Apple posterior view video technique was used to examine Japanese porcine eyes. Lensectomy was performed by phacoemulsification and irrigation and aspiration (I/A). An IOL stained with black pigment was inserted into the lens capsule. In order to visualize the fluid dynamics, triamcinolone acetonide?was added to irrigation solution during I/A. The fluid dynamics of the irrigation solution above and below the IOL were observed and recorded using the surgical view and the Miyake-Apple posterior view. Two I/A techniques for irrigation under the IOL were compared. In one group, the I/A cannula was positioned on the center of the IOL, while in the other group, the I/A cannula was intermittently placed on one horizontal edge of the IOL to tilt the IOL (tapping method).

Results:

By using triamcinolone acetonide, we were able to introduce particles into the irrigation solution while avoiding precipitation. This allowed us to visualize the dynamics of the irrigation solution under the IOL. When the I/A cannula was positioned on the center of the IOL, the irrigation solution behind the IOL flowed in a straight line, but more slowly than solution in the anterior chamber. In contrast, in the tapping method, irrigation solution under the IOL flowed rapidly in a spiral pattern.

Conclusions:

Triamcinolone acetonide allowed for visualization of irrigation solution under the IOL. The tapping technique created rapid flow under the IOL, suggesting that the tapping technique can effectively propel irrigation solution out from under the IOL and remove OVD. FINANCIAL DISCLOSURE?: No