Skip to main content

Advertisement

Log in

Influence of irrigation dynamic pressure-assisted hydrodissection on intraocular pressure and the posterior chamber-anterior hyaloid membrane barrier during cataract surgery

  • Laboratory Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the effects of irrigation dynamic pressure-assisted hydrodissection (irrigation-hydro: iH) on intraocular pressure (IOP) and the posterior chamber-anterior hyaloid membrane (PC-AHM) barrier in porcine eyes.

Study design

Experimental.

Methods

In Experiment 1, IOP was recorded while irrigating the anterior chamber (AC), during iH, and during phacoemulsification and aspiration in 20 porcine eyes using bottle heights of 50, 70, and 90 cm. Under the same conditions, IOP was recorded during conventional manual cortical cleaving hydrodissection (manual hydro: mH) in 20 porcine eyes. In Experiment 2, after iH, ACs were perfused for 5 seconds with balanced salt solution containing 1.0-μm fluorescein beads in 20 porcine eyes using bottle heights of 70, 118, and 169 cm. PC-AHM barrier staining grade was evaluated by the Miyake-Apple view.

Results

iH proved successful in all cases. In Experiment 1, IOP during iH was relatively stable and peak IOP was below the baseline bottle height-dependent pressure. No eyes showed a peak IOP > 75 mmHg during iH, but 8 eyes showed a peak IOP > 75 mmHg during mH. In Experiment 2, neither AHT nor ruptured capsules were observed at any bottle height.

Conclusion

Unlike mH, IOP during iH was relatively stable without any high peak IOP. Thus, iH offers a simple technique for reducing peak IOP and avoiding disturbance of the PC-AHM barrier.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Faust KJ. Hydrodissection of soft nuclei. Am Intra-Ocular Implant Soc J. 1984;10:75–7.

    Article  CAS  Google Scholar 

  2. Fine IH. Cortical cleaving hydrodissection. J Cataract Refract Surg. 1992;18:508–12.

    Article  PubMed  CAS  Google Scholar 

  3. Vasavada AR, Singh R, Apple DJ, Trivedi RH, Pandey SK, Werner L. Effect of hydrodissection on intraoperative performance: randomized study. J Cataract Refract Surg. 2002;28:1623–8.

    Article  PubMed  Google Scholar 

  4. Khng C, Packer M, Fine IH, Hoffman RS, Moreira FB. Intraocular pressure during phacoemulsification. J Cataract Refract Surg. 2006;32:301–8.

    Article  PubMed  Google Scholar 

  5. Kawasaki S, Tasaka Y, Suzuki T, Zheng X, Shiraishi A, Uno T, et al. Influence of elevated intraocular pressure on the posterior chamber-anterior hyaloid membrane barrier during cataract operations. Arch Ophthalmol. 2011;129:751–7.

    Article  PubMed  Google Scholar 

  6. Ohnuma O, Matsushima H, Senoo T, Obara Y. Intraocular pressure change during phacoemulsification and aspiration. Atarashii Ganka. 2006;23:1225–7 (in Japanese).

    Google Scholar 

  7. Hurvitz LM. Posterior capsular rupture at hydrodissection (letter). J Cataract Refract Surg. 1991;17:866.

    Article  PubMed  CAS  Google Scholar 

  8. Osher RH, Yu BC, Koch DD. Posterior polar cataracts: a predisposition to intraoperative posterior capsular rupture. J Cataract Refract Surg. 1990;16:157–62.

    Article  PubMed  CAS  Google Scholar 

  9. Ota I, Miyake S, Miyake K. Dislocation of the lens nucleus into the vitreous cavity after standard hydrodissection. Am J Ophthalmol. 1996;121:706–8.

    Article  PubMed  CAS  Google Scholar 

  10. Miyake K, Ota I, Ichihashi S, Miyake S, Tanaka Y, Terasaki H. New classification of the capsular block syndrome. J Cataract Refract Surg. 1998;24:1230–4.

    Article  PubMed  CAS  Google Scholar 

  11. Roberts TV, Sutton G, Lawless MA, Jindal-Bali S, Hodge C. Capsular block syndrome associated with femtosecond laser-assisted cataract surgery. J Cataract Refract Surg. 2012;38:672–6.

    Article  Google Scholar 

  12. Mackool RJ, Sirota M. Infusion misdirection syndrome. J Cataract Refract Surg. 1993;19:819.

    Google Scholar 

  13. Gryzmowski A, Prasad S. Acute aqueous misdirection syndrome: pathophysiology and management. J Cataract Refract Surg. 2014;40:2167.

    Google Scholar 

  14. Marques FF, Marques DMV, Osher RH, Osher JM. Fate of anterior capsule tears during cataract surgery. J Cataract Refract Surg. 2006;32:1638–42.

    Article  PubMed  Google Scholar 

  15. Masuda Y, Iwaki H, Kato N, Takahashi G, Oki K, Tsuneoka H. Irrigation dynamic pressure assisted hydrodissection during cataract surgery. Clin Ophthalmol. 2017;11:323–8.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Masuda Y, Oki K, Iwaki H, Okamoto T, Tsuneoka H. Use of the phaco tip technique for lens cleavage and removal during cataract surgery. Clin Ophthalmol. 2016;10:1925–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Miyake K, Miyake C. Intraoperative posterior chamber lens haptic fixation in the human cadaver eye. Ophthalmic Surg. 1985;16:230–6.

    PubMed  CAS  Google Scholar 

  18. Apple DJ, Lim ES, Morgan RC, Tsai JC, Gwin TD, Brown SJ, et al. Preparation and study of human eyes obtained postmortem with the Miyake posterior photographic technique. Ophthalmology. 1990;97:810–6.

    Article  PubMed  CAS  Google Scholar 

  19. Masuda Y, Tsuneoka H. Hydrodissection-free phacoemulsification surgery: mechanical cortical cleaving dissection. J Cataract Refract Surg. 2014;40:1327–31.

    Article  PubMed  Google Scholar 

  20. Soda M, Yaguchi S. Phacoemulsification without hydrodissection: Semi-crater and split technique. J Cataract Refract Surg. 2015;41:1132–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Toshinori Okamoto and Tadashi Nakano for their helpful suggestions regarding this study.

Conflicts of interest

N. Kato, None; Y. Masuda, None; K. Oki, None; H. Iwaki, None; H. Tsuneoka, Grant (Abbott Medical Optics, Alcon, Daiichi Sankyo, Kowa, MSD, Nidek, Otsuka, Santen, Senju), Lecture fees (Abbott Medical Optics, Alcon, Bausch + Lomb, HOYA, Kowa, Nidek, Otsuka, Pfizer, Santen, Senju).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Noriko Kato.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Corresponding author: Noriko Kato

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MP4 35859 kb)

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kato, N., Masuda, Y., Oki, K. et al. Influence of irrigation dynamic pressure-assisted hydrodissection on intraocular pressure and the posterior chamber-anterior hyaloid membrane barrier during cataract surgery. Jpn J Ophthalmol 63, 221–228 (2019). https://doi.org/10.1007/s10384-018-00646-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-018-00646-3

Keywords

Navigation