The influence that ophthalmic viscosurgical device gives intra ocular pressure during small incision and ultra small incision cataract surgeries

Takuya Shiba, Takako Torisu, Akiko Hayama Katsuya Mitooka, Hiroshi Tsuneoka

Department of OphthalmologyJikei University School of MedicineTokyo, JapanThe authors have no financial interest in the products mentioned in this poster

Jikei University School of Medicine, Tokyo, Japan

Objective

• Using the experimental model we originally prepared, we estimated the difference in the inner pressure of the anterior chamber filling a different type of ophthalmic viscosurgical devices (OVD) in hydrodissection during small incision and ultra small incision cataract surgeries.

Jikei University School of Medicine, Tokyo, Japan

Methods 1/3

• We made the diameter of the top of the pipettes 1.5mm (micro bimanual phaco group), 2.4mm (micro coaxial phaco group), and 3.0mm (coaxial phaco group).

1.5mm

2.4mm

3.0mm

Jikei University School of Medicine, Tokyo, Japan

Methods 2/3

• Filled the pipettes with OVD, and applied 5mmHg of constant pressure, using a pressure pump to imitate the process of hydrodissection, and then measured the inner pressure of the pipettes.

Jikei University School of Medicine, Tokyo, Japan

Methods 3/3

• Used 4 types of OVD– Low Viscosity Dispersive

• Opegan (Santen, Japan) – Midium Viscosity Dispersive

• Viscoat (Alcon, USA).– Viscous Cohesive

• Opegan Hi (Santen, Japan) – Viscoadaptive

• Healon 5 (AMO, USA)

Jikei University School of Medicine, Tokyo, Japan

Results 1/2

3.0mmCoaxial Phaco

2.4mmMicro Coaxial Phaco

1.5mmMicro Bimanual Phaco

Viscoat Healon 5

Opegan HiOpegan Viscoat Healon 5

Opegan HiOpegan Viscoat Healon 5

Opegan Opegan Hi

20

60

100mmHg

20

60

100mmHg

20

60

100mmHg

Jikei University School of Medicine, Tokyo, Japan

Results 2/2

• The micro coaxial and micro bimanual groups have shown a difference in the inner pressure with Opegan and other OVDs that is greater than that of the coaxial group.

Jikei University School of Medicine, Tokyo, Japan

Discussion

• Intraocular Pressure / Incision Size (mm)– Low Viscosity Dispersive (Opegan, etc)

• 3.0 ≈ 2.4 ≈ 1.5– Viscous Cohesive (Opegan Hi, etc)

• 3.0 ≈ 2.4 < 1.5– Midium Viscosity Dispersive (Viscoat, etc)

• 3.0 ≈ 2.4 <<1.5– Viscoadaptive (Healon 5, etc)

• 3.0 < 2.4 <<<1.5

Jikei University School of Medicine, Tokyo, Japan

Conclusion

• Our results suggested the necessity of selecting a low-molecular dispersive type of ophthalmic viscosurgical device for anterior capsulotomy when we implement small-incision and micro-incision cataract surgeries.