Spending 40 cc in an entire Cataract Surgery. Comparative study.

Arturo Pèrez-Arteaga M.D.Medical Director & FounderCentro Oftalmològico Tlalnepantla, Mèxico.Poster for ASCRS, San Francisco, 2009.

No Finantial Interest

Background

Currently Micro-Incisional Cataract Surgery Techniques are gaining field against traditional ones.

Both, Micro-Coaxial & Micro-Biaxial are showing advantages in particular in fluidics.

A debate exist between promoters of each technique regarding the advantages and disadvantages.

Objective & Type of Study

To determine which Micro-Incisional Cataract Technique utilizes less amount of irrigation inside the eye.

Comparative, prospective, randomized study between Micro-Coaxial & Micro-Biaxial techniques.

Material & Methods

50 eyes of uncomplicated senile cataract were operated by the same surgeon and divided in two randomized groups.

25 were operated with Micro-Coaxial technique (1.6 mm incision); Oertli Phaco System and passive infusion.

25 were operated with Micro-Biaxial technique (0.7 mm incision); Accurus Phaco System and forced infusion.

The amount of total Intraocular Saline Solution was measured in all cases, and both groups were compared.

Forced Infusion

Internal Forced Infusion created with the Accurus Surgical System

Active irrigation through a 25G cannula

Results

The Micro-Coaxial group used an average of 69 cc in the entire procedure.

The Micro-Biaxial group used an average of 42 cc in the entire procedure, including I/A.

Results

The Micro-Incisional Technique that utilizes less amount of Intraocular Solution during the entire surgery was Micro-Coaxial

The differente has statistical significance.

Results

Bottle starting a Micro-Biaxial case Bottle ending the same case.

Discussion

As much as the amount of infusion is lower in the anterior chamber, less trauma over the endothelial cells is obtained.

Discussion

Further studies are needed to determine the exact significance of less irrigating volume in the postoperative state of the cornea.

References

Agarwal A. Agarwal A. et al. Phakonit phacoemulsification trough a 0.9 mm corneal incision. J Cataract Refract. Surg. 2001;27:1548-1552.

Agarwal A. Agarwal A. et al. Phakonit: Lens removal trough a 0.9 mm incision. J Cataract Refract Surg. 2001;27:1531-1532.

Agarwal A. Agarwal S. Agarwal A. Phakonit and laser phakonit: lens removal trough a 0.9-mm incision. Phacoemulsification, laser cataract surgery and foldable IOL´s. New Delhi, India: Jaypee; 2000; 204-216.

Tsuneoka H. Shiba T.Feasibility of ultrasound cataract surgery trough a 1.4 mm incision. Journal Cataract and Refractive Surgery, 2001; 27, 934-940.

Agarwal, Amar. Bimanual 0.9 mm approach to phaco promises astigmatic neutral cataract surgery and faster rehabilitation. Eurotimes, February 2003.

Alió, Jorge. MICS ready to go. Ocular Surgery News, March, 2003. Pérez-Arteaga, Arturo. Accurus Forced Infusión good for MICS. Ocular Surgery

News, 6/15/03. Pérez-Arteaga, Arturo. Bottle Infusión Tool of the Millennium Surgical System

for Phakonit. Ocular Surgery News; 09/15/03. Pérez-Arteaga, Arturo. Anterior Vented Gas Forced Infusion of the Accurus

Surgical System for Phakonit. J Cataract Refract Surg. April 2004. Pèrez-Arteaga, Arturo. Step by Step to Biaxial Lens Surgery. Jaypee Bros.

Publishers. India, 2008.