Abstract
Purpose :
Currently, small incisions are common in cataract surgery, and 2.0mm to 2.4mm incisions are commonly used. However, there are some complications, such as crush injury at the incision wound due to the surgical procedure involving injector insertion and nozzle design. Previously, we used hematoxylin and eosin staining and SEM to observe the effects of crush injury. However, evaluation with these methods is tedious and prolonged and does not provide quantification. As a solution, we report a method to quantitatively evaluate crush injury states by automated image analysis using a programming language (Python), and the results of the validation of the test system.
Methods :
Porcine corneas were incised with phaco knives (MANI, INC.) to the recommended incision sizes, and an IOL was inserted into each eye using the NSP-2(Nidek Co., Ltd.,) or the SZ-1(Nidek Co., Ltd.,) injectors. Anterior segment OCT was performed of the incision wounds after the incision and after nozzle insertion/lens insertion. The crush injury rates were calculated for both injectors using automated image analysis. (n4)
Previously, Sobajima et al (ARVO 2021) reported that the NSP-2 has a smaller injector nozzle circumference than the SZ-1 and is less likely to cause crush injury. Therefore, this test system was validated by confirming that the crush injury rate of the NSP-2 is within the 99.7% confidence interval for the SZ-1 crush injury rate.
Results :
For the SZ-1, the average crush injury rate was 3.75±1.191% (range,0.18% to 7.32%) after incision and 8.40±1.277% (range,4.57% to 12.23%) after insertion. For the NSP-2, the average crush injury rate was 3.66±0.907% (range,1.26% to 5.99%) after incision and 8.9±0.598% (range,4.80% to 12.20%) after insertion.
Conclusions :
The quantitative evaluation was validated because it confirmed that crush injury rate of the NSP-2 injector was within the 99.7% confidence interval for the crash injury rate of the SZ-1. Hence, the validation of this test system indicates it is a suitable method for quantitative evaluation of crush injury in cataract surgery.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.