Minimizing immediate post operative IOP rise with good visual acuity by not leaving any OVD behind IOL at the end of the phacoemulsification surgery

Poster Details

First Author: S.Sinha INDIA

Co Author(s):    P. Sinha              

Abstract Details

Purpose:

One of the major reasons for rise in IOP immediately after surgery is due to remenant OVD behind the IOL which blocks the trabecular meshwork. Beginners and other phacoemulsification surgeons also dread to go behind the IOL to remove the OVD used during IOL insertion. We wanted to evaluate if immediate post operative visual acuity and IOP was better by using OVD just before IOL insertion or was it better when OVD was not used at all.

Setting:

This is a single center retrospective study conducted at an eye hospital in Northern India. Same surgeon with an experience of 10 years did all the surgeries with the same phaco machine settings on patients having same the grade of cataract. Corneal and retinal status of all patients were within normal limits. All surgeries were uneventful.

Methods:

38 patients were enrolled for this study with due conscent. In 17 patients OVD was used during IOL insertion and thereafter it was washed with BSS. Every effort was made to carefully remove as much OVD as possible without hurting the posterior capsule. In 21 patients no OVD was used. The irrigating canula was inserted through the side paracentesis in ON mode, to fill the bag with BSS and maintain it in that position. As will be seen in the video, apart from keeping the ‘Bag’ open, the irrigating cannula also helped in stabilizing the eye while with the other hand the IOL was inserted through the main port. No OVD was used in this IOL insertion.

Results:

Visual acuity ( Snellen’s ) and IOP were checked ( by NCT ) 2 hours after surgery for all the patients. Patients in whom OVD was not used had better clarity of vision and better IOP control as compared to those in whom OVD was used to insert the IOL.

Conclusions:

Many surgeons, especially beginners, face a lot of difficultly in going behind the IOL to wash the OVD which was used just before IOL implantation. Using the irrigating probe with irrigation ON and keeping the ‘bag’ fully filled with BSS, is a good method to prevent the difficulties of cleaning the remenant OVD behind the IOL. Better patient satisfaction was seen 2 hours post phaco surgery with better visual acuity and normal IOP. FINANCIAL DISCLOSURE?: No