First Author: V.Zygoura UK
Co Author(s): N. Kopsachilis E. Papavasileiou C. Cunningham
Purpose:
Posterior capsule opacification is the most common long-term complication after phacoemulsification. Methods of reducing its incidence include the development of novel surgical techniques, intraocular lens materials and designs. The purpose of this study is to evaluate the effectiveness of the “jet blasting” technique in the prevention of posterior capsule opacification 4 years postoperatively.
Setting:
: Single surgeon ophthalmology practice, Moorfields Eye Hospital, London, UK
Methods:
The data of 129 consecutive patients who underwent phacoemulsification and implantation of a single-piece hydrophilic acrylic intraocular lens by a single surgeon from September to December 2008 were analyzed.
'The jet-blasting' technique was performed after removing the natural lens by phacoemulsification. The posterior bag was filled with hydroxypropyl methylcellulose (HPMC) prior to insertion of a posterior chamber intraocular lens. The posterior capsule was then 'jet blasted' by using a 25G Ricroft cannula attached to a 5 ml syringe by filled with balanced salt solution (BSS) placed close to the capsule to meticulously scroll off any residual epithelial cells or cortical matter in the central 6-8 mm zone.
All surgical complications, residual fibrosis of the posterior capsule OR patients with post-operative uveitis were excluded. All patients had standardized postoperative medication and follow-up. Data regarding the YAG capsulotomy rate were recorded from the patients’ notes.
The “Jet blasting” technique was simulated in an in vitro experimental setup to assess our clinical findings. The anterior capsule of 10 patients previously operated for routine phacoemulsification was removed and examined under phase contrast microscope for residual epithelial cells prior and after an in vitro “Jet blasting” was performed on the anterior capsules.
Results:
No intraoperative complications were noted when using the “Jet blasting” technique. 5 patients were excluded from our study due to postoperative uveitis. The YAG capsulotomy rate of our 124 patients was statistically significantly lower (p<0.05) compared to YAG capsulotomy rates reported in the literature regarding hydrophilic acrylic intraocular lenses. No complications were observed.
The density of residual epithelial cells on the anterior capsules after the in vitro application of “Jet blasting” was statistically significantly lower in our experimental laboratory setup.
Conclusions:
“Jet blasting” is a novel and safe technique that can potentially reduce Yag capsulotomy rates for single-piece hydrophilic acrylic intraocular lenses.
Financial Disclosure:
None
