Abstract
Purpose:
The purpose of the study is to compare the incidence of postoperative intraocular pressure (IOP) spikes following cataract surgery using disposable, silicone irrigation/aspiration (I/A) tips versus reusable, metal I/A tips. Clogging of the reusable, metal I/A tips, due to inadequate cleaning, was found to result in suboptimal vacuum power and incomplete cortical lens material removal. Consequently, it was hypothesized that there would be an increased incidence of post-operative IOP spikes due to retained cortical lens material in the reusable I/A tip group.
Methods:
A retrospective chart review was performed of 92 consecutive eyes that underwent cataract surgery by one surgeon. 50 eyes from 34 different patients had cataract surgery using reusable, metal I/A tips; 42 eyes from 29 different patients had cataract surgery using Alcon Ultraflow disposable, silicone I/A tips. 20% and 21.4% of eyes were diagnosed with and being treated for glaucoma or ocular hypertension from the reusable I/A tip group and disposable I/A tip group, respectively. IOP spikes were defined as a postoperative day one IOP > 30mm Hg or a postoperative IOP increase >15mm Hg from one’s most recent pre-operative IOP.
Results:
16% (8 eyes) and 11.9% (5 eyes) experienced post-operative IOP spikes in the reusable and disposable I/A tip groups, respectively. 50% (5 eyes) and 11% (1 eye) of glaucomatous or ocular hypertensive eyes experienced postoperative IOP spikes in the reusable and disposable I/A tip groups, respectively.
Conclusions:
Eyes that underwent cataract surgery using disposable, silicone I/A tips were noted to have a 25.6% lower incidence in post-operative IOP spikes compared to eyes that underwent cataract surgery using reusable, metal I/A tips. Additionally, glaucomatous or ocular hypertensive eyes were noted to have a 78% lower incidence in post-operative IOP spikes when using disposable, silicone I/A tips. Accordingly, using disposable, silicone I/A tips during cataract surgery may result in a lower incidence of postoperative IOP spikes, particularly in glaucomatous or ocular hypertensive eyes. Further prospective studies with a greater number of enrolled eyes will need to be conducted to further explore relationships between disposable and reusable I/A tips in cataract surgery.
Keywords: 445 cataract •
568 intraocular pressure