Abstract
Purpose: :
Phacoemulsification with use of an OVD is the preferred technique of modern cataract surgery. The OVD maintains the anterior chamber, protects the corneal endothelium and facilitates IOL implantation. The clinical impression is that dispersive OVDs retain in the anterior chamber and consequently protect the endothelium better during phacoemulsification than cohesive OVDs. The purpose of our 3D evaluation was to visualize OVD maintenance of the anterior chamber in a novel way and provide further insight of OVD performances during cataract surgery.
Methods: :
Cataract surgery was simulated ex vivo in porcine eyes. OVDs were stained with fluorescein, 6 µg/ml, for detection purposes. Each step of the surgical procedure was monitored by a 3D-scan of digital slit-illumination photographs. The anterior chamber depth was measured before surgery, after injection of OVD, and after phacoemulsification. For each product studied at least nine eyes were used. Products tested were the Healon, Healon GV, Healon5, and Healon D OVDs covering the whole range of dispersive and cohesive OVDs.
Results: :
The 3D-picture captured the remaining OVD in a novel way. After phacoemulsification both the dispersive Healon D OVD and the viscoadaptive Healon5 OVD were retained in the anterior chamber, while the cohesive products were removed to different extent.
The same eye A) before surgery and with B) Healon 5 OVD after phacoemulsification: Pentacam 3D-model with 60°-cutout.
Conclusions: :
By use of the 3D-mode of the Pentacam the retention of OVDs after simulated cataract surgery has for the first time been visualized in 3D. The clinical impression that dispersive OVDs retain in the anterior chamber better than cohesive OVDs is valid which also holds true for the Healon5 OVD. By using this technique better understanding of OVD performance during surgery may evolve.
Keywords: imaging/image analysis: non-clinical • small incision cataract surgery • anterior chamber