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. 2019 Oct;67(10):1634-1637.
doi: 10.4103/ijo.IJO_465_19.

Impact of fluidic parameters during phacoemulsification on the anterior vitreous face behavior: Experimental study

Vaishali Vasavada  1 , Samaresh Srivastava  1 , Viraj Vasavada  1 , Shail Vasavada  1 , Abhay R Vasavada  1 , Aditya Sudhalkar  1 , Alper Bilgic  1
Affiliations

Impact of fluidic parameters during phacoemulsification on the anterior vitreous face behavior: Experimental study

Vaishali Vasavada et al. Indian J Ophthalmol. 2019 Oct.

Abstract

Purpose: To evaluate the eff ect of different aspiration flow rates (AFR) and bottle heights (BH) on vitreous face (AVF) during phacoemulsifi cation.

Methods: Experimental study in 20 porcine eyes. Transzonular viscodissection was performed between the posterior capsule(PC) and AVF to dissect out the Berger's space. Triamcinolone acetonide was injected into this space to aid visualization with ultrasound B-Scan(USG). Realtime USG was performed during phacoemulsifi cation. Eyes were divided randomly into-Group I: Low parameters(AFR = 20 cc/min, BH = 90 cm, vacuum = 400 mmHg),and Group II: High parameters (AFR = 40 cc/min, BH = 110 cm, vacuum=650 mm Hg).

Results: 15 eyes were analysed (8 in Group I; 7 in Group II). In all eyes, forward and backward movement of the PC was seen when going from foot position 0 to 1, or on occlusion break. Amplitude of these movements was much greater in Group II compared to Group I. There was no PC rupture in either group. In 2 of the 7 eyes in Group II, USG showed a sudden, spontaneous dispersion appearance of sono-opaque echoes in the vitreous cavity alongwith disappearance of the well-defi ned, crescentic stained space despite an intact PC. This suggests rupture of the AVF, leading to dispersion of the triamcinolone into the entire vitreous cavity. No AVF rupture was seen in Group I.

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

Keywords: Anterior vitreous face; fluidic parameters; intact posterior capsule; phacoemulsification.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a and b). Phacoemulsification being performed in porcine eye, and real-time ultrasound B scan being performed with the probe positioned over the cornea
Figure 2
Figure 2
(a and b). Ultrasound B-Scan image showing the stained and expanded Berger's space bound on one side by the posterior capsule, and on the other, by the anterior vitreous face
Figure 3
Figure 3
Sono-opaque shadows seen in the vitreous cavity, suggestive of triamcinolone dispersion in the vitreous cavity
See this image and copyright information in PMC

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References

    1. Moorhead LC, Armeniades CD. Variations in intraocular pressure during closed system surgical procedures. Arch Ophthalmol. 1986;104:269–72. - PubMed
    1. Armeniades CD, Moorhead LC. Hydrodynamic analysis of intraocular pressure changes during anterior chamber procedures. J Cataract Refract Surg. 1992;18:444–8. - PubMed
    1. Findl O, Strenn K, Wolzt M, Menapace R, Vass C, Eichler HG, et al. Effects of changes in intraocular pressure on human ocular haemodynamics. Curr Eye Res. 1997;16:1024–9. - PubMed
    1. Quigley HA, McKinnon SJ, Zack DJ, Pease ME, Kerrigan-Baumrind LA, Kerrigan DF, et al. Retrograde axonal transport of BDNF in retinal ganglion cells is blocked by acute IOP elevation in rats. Invest Ophthalmol Vis Sci. 2000;41:3460–6. - PubMed
    1. Moorhead LC, Gardner TW, Lambert HM, O’Malley RE, Willis AW, Meharg LS, et al. Dynamic intraocular pressure measurements during vitrectomy. Arch Ophthalmol. 2005;123:1514–23. - PubMed