Impact of anterior chamber fluctuations during phacoemulsification on the anterior vitreous face behavior

Session Details

Session Title: Evolution in FLACS & Phaco Technology

Session Date/Time: Sunday 23/09/2018 | 08:00-09:45

Paper Time: 09:20

Venue: Room A3, Podium 2

First Author: : S.Srivastava INDIA

Co Author(s): :    S. Vasavada   A. Vasavada   V. Vasavada   V. Vasavada           

Abstract Details

Purpose:

Evaluate the effect of different aspiration flow rate(AFR) and bottle height(BH)) on posterior capsule and anterior vitreous face(AVF) during phacoemulsification

Setting:

Iladevi Cataract & IOL Research Centre, Raghudeep Eye Hospital, Ahmedabad, India

Methods:

Experimental study in 20 porcine eyes. Transzonular viscodissection performed between the posterior capsule(PC) and AVF to dissect out the Berger’s space. Triamcinolone acetonide injected into this space which acted as a sono-opaque marker that aided visualization of the dissected space with ultrasound B-Scan(USG). Realtime USG B-Scan was performed during surgery. Eyes were divided randomly into two groups; Group I :High parameters(AFR=40 cc/min, BH 110 cm ,Vacuum=650 mmHg)and low parameters parameters (AFR=20 cc/min, BH 90 cm ,Vacuum=400 mm Hg)

Results:

17 eyes were analysed(8 Group I;9 in Group.II).In all eyes forward and backward movement of the PC was seen when going from foot position 0to1,or on occlusion break.Amplitude of these movements was much greater in Gr.I compared to Gr.II.In both groups,PC was intact.In some eyes,USG B-Scan showed a sudden and spontaneous dispersion of the triamcinolone into the vitreous cavity,and a disappearance of the well-defined,crescentic triamcinolone containing space despite intact PC.This suggests rupture of the AVF barrier, leading to dispersion of the triamcinolone into the entire vitreous cavity.AVF rupture was seen in 3 eyes in Group I,and none in Group II

Conclusions:

We report a rarely described entity of AVF rupture with intact PC. sThe use of high AFR,BH and vacuum may have clinically invisible detrimental consequences to the AVF and anterior vitreous

Financial Disclosure:

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