Session Title: Cataract II
Session Date/Time: Saturday 16/02/2013 | 08:30-11:00
Paper Time: 09:11
Venue: Hall 1
First Author: : E.Sykakis UK
Co Author(s): : M. Kinsella R. Karim S. Patel M. Bhogal D. Parmar
Purpose:
To assess an adherent ocular bandage for clear corneal incisions in cataract surgery using anterior segment optical coherence tomography to assess wound structure and trypan blue as a quantifiable ingress tracer to determine whether adherent ocular bandage reduces ocular surface contaminants ingress after routine surgery.
Setting:
Whipps Cross University Hospital, London, United Kingdom.
Methods:
A prospective randomised controlled clinical study included 24 eyes having phacoemulsification through 2.8mm 3 step clear corneal incision. 2 eyes were used as positive and 2 as negative controls. The rest of the eyes were divided into two equal groups. Group 1 where 10 eyes had an ocular adherent ocular bandage applied to the corneal incision at the end of the surgery and group 2 where 10 eyes had routine management without stromal hydration. At the end of the surgery, 2ml of trypan blue was instilled on the ocular surface and allowed to remain for 2 minutes. 0.1 ml of aqueous fluid was aspirated from the anterior chamber and its optical density was measured using ultraviolet spectrophotometry. The corneal incisions were examined postoperatively within 2 hours, at 24 hours and 7 days using anterior segment optical coherence tomography imaging and slit lamp fluorescein 2% Seidel test.
Results:
All of the corneal incisions were Seidel negative. The mean intraocular pressure in the immediate postoperative period was 18.34±1.69 for group 1 and 17.33±3.09 for group 2 (p>0.05%). No architectural differences of the incisions between the 2 groups were noted apart from the external appearance of the incisions of group 1 that were covered by the adherent ocular bandage. The total mean length of the 3 step corneal incisions in group 1 and group 2 were 2410±371μm and 2392±221μm respectively (p>0.05%). Although we managed to achieve accurate measurements of trypan blue dilutions down to 1:100.000 at absorbance of 585nm our laboratory setting, no trace of trypan blue could be found in any of the samples taken from the 20 eyes and the measurement was in agreement with our negative control samples.
Conclusions:
There was no difference in the ingress of trypan blue or corneal incision architecture between the two groups. Although adherent ocular bandages are a very useful tool in cataract surgery, proper wound construction is of utmost importance.
Financial Disclosure:
None
