Frequency, source, and prevention of cotton fibers in the anterior chamber during cataract surgery

Abstract

Purpose: To prospectively evaluate the frequency of fibers in the anterior chamber during and after cataract surgery, their source, and preventive measures.

Setting: Department of Ophthalmology, Setagaya-Shimoda Hospital, Tokyo, Japan.

Methods: Slitlamp biomicroscopy was used to examine 422 eyes after cataract surgery for frequency of fibers in the anterior chamber. In another 78 eyes having cataract surgery, fibers in the anterior chamber were removed and compared with fibrous materials used during surgery using microscopic and Raman spectrometric analyses. Dust-generation tests were conducted on the fibrous materials used in surgery. In 337 eyes having cataract surgery, highly dust-generating materials were excluded during surgery and the frequency of fibers in the anterior chamber was determined.

Results: After surgery, fibers were detected in the anterior chamber in 7 (1.7%) of 422 eyes. No inflammation was observed during a 1-year follow-up. During surgery, fibers suspended in the anterior chamber were observed in 5 (6.4%) of 78 eyes. Microscopic and Raman spectrometric analyses showed that the fibers were identical to the cotton fibers in cotton balls and gauze. Cotton balls had the highest dust-generation rate of fibrous materials used intraoperatively. Excluding cotton balls significantly reduced the frequency of fibers to 5 (1.5%) of 337 eyes (P = .0239).

Conclusions: During routine cataract surgery, fibers were introduced into the anterior chamber in 6.4% of cases. Of the fibrous materials used in surgery, cotton balls generated the most fibers. Eliminating cotton balls alone significantly reduced the frequency of fibers in the anterior chamber to 1.5%.