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Yoshihiro Koide 1 Contributing authors: Hiroyuki Matsushima 1 , Tadashi Senoo 1 , Kotaro Oki 2

Ingenuity method using viscoadaptive device to protect endothelial cell damage during cataract surgery. Yoshihiro Koide 1 Contributing authors: Hiroyuki Matsushima 1 , Tadashi Senoo 1 , Kotaro Oki 2 1 Department of Opthalmology Dokkyo Medical University(Japan) 2 Oki Eye Surgery Center(Japan).

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Yoshihiro Koide 1 Contributing authors: Hiroyuki Matsushima 1 , Tadashi Senoo 1 , Kotaro Oki 2

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  1. Ingenuity method using viscoadaptive device to protect endothelial cell damage during cataract surgery Yoshihiro Koide1 Contributing authors: Hiroyuki Matsushima1, Tadashi Senoo1, Kotaro Oki2 1Department of Opthalmology Dokkyo Medical University(Japan) 2Oki Eye Surgery Center(Japan) No Financial Interest

  2. Purpose Remaining ophthalmic visco device (OVD) in anterior chamber (AC) during phacoemulcification(PEA) is important to protect endothelial cells. In this study an ingenious method to remain OVD during PEA is evaluated.

  3. We found differences by method of injecting OVD for remaining in AC. Usual exchange Complete exchange When the OVD inject from center of cornea, it is difficult to fill OVD on peripheral. When the OVD inject from opposite side of incision, it is easy to fill out OVD completely.

  4. Is complete exchange effective? Healon V (AMO) is prepared and stained with fluorescein sodium for visualize. Two different OVD exchange methods are performed to pig eyes. Remained OVD is observed after PEA. Grade 0: OVD is disappeared from AC at end of PEA. Grade 1: OVD is partially remained in AC at end of PEA. Grade 2: OVD is remained in AC at end of PEA.

  5. Is complete exchange effective? Usual exchange Complete exchange Pre Pre Post Post The OVD partially disappeared after PEA. The OVD still remained in AC after PEA.

  6. Is complete exchange effective? Usual exchange Complete exchange Grade Five surgeons tests the two different methods. The complete exchange is effective to remain OVD in AC after PEA.

  7. Clinical evaluation • 36 cataract patients are randomly separated into two groups. S-group (18 eyes) Soft-shell technique using Viscort (Alcon) and Healon (AMO) V-group (18 eyes) Complete exchange by Healon V (AMO) Viscort Healon Healon V

  8. Clinical evaluation • PEA is performed using Accurus (Alcon). • Bottle height 60 cm, • Aspiration 160 mmHg, power 70% • Percentages of corneal endothelial cell loss and ocular pressure are measured 1,3 and 6 months postoperatively. • Unpaired t-test is performed for statistical analysis.

  9. The percentages of endothelial cell loss ＊ ＊ ＊ 2.93 2.84 2.14 1.54 1.13 0.75 ＊Unpaired t-test; P<0.05 The percentages of endothelial cell loss was lower in V- group than in S-group.

  10. Intraocurar Pressure mmHg ＊There are no statistically significance. There are no differences of intraocular pressure preoperatively between two groups.

  11. Conclusion • Healon V was able to remain AC by ingenious complete exchange methods after PEA. • Complete exchange AC using Healon V was effective to protect endothelial cell loss.

  12. To protect endothelial cell loss… Complete exchange • Not only the types of OVD but also the injection method of OVD during PEA were important to protect endothelial cell loss. When the OVD inject from opposite side of incision, it is easy to fill out OVD completely.

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