Journal of cataract and refractive surgery · 2013
Incision integrity and postoperative outcomes after microcoaxial phacoemulsification performed using 2 incision-dependent systems.
Сравнительное исследованиеСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Vasavada Vaishali, Vasavada Abhay R, Vasavada Viraj A, Srivastava Samaresh, Gajjar Devarshi U, Mehta Siddharth
Аннотация
PURPOSE: To compare incision integrity and clinical outcomes of 2 microcoaxial phacoemulsification systems.
SETTING: Iladevi Cataract & IOL Research Centre, Ahmedabad, India.
DESIGN: Prospective randomized clinical trial.
METHODS: Eyes were randomized to have phacoemulsification using a 1.8 mm clear corneal incision (CCI) system (Group 1, Stellaris system) or a 2.2 mm CCI system (Group 2, Intrepid Infiniti system). Incision enlargement at end of surgery was measured. At the conclusion of surgery, trypan blue was applied over the conjunctival surface, anterior chamber aspirate withdrawn, and ingress into anterior chamber measured. Postoperative observations included evaluation of the CCI using anterior segment optical coherence tomography (AS-OCT), change in central corneal thickness (CCT), and anterior segment inflammation at 1 day, 1 week, and 1 month and endothelial cell loss and surgically induced astigmatism (SIA) at 3 months.
RESULTS: Incision enlargement (P<.001) and trypan blue ingress in the anterior chamber (mean 1.7 log units ± 0.6 [SD] versus 3.8 ± 0.6 log units, P<.001) was significantly greater in Group 1 (n = 50) than in Group 2 (n = 50). On AS-OCT, endothelial misalignment and gaping were more frequent in Group 1 at 1 day (P=.001) and 1 week (P=.018). There were no significant differences in SIA, change in CCT, endothelial cell loss, or anterior segment inflammation (P>.05).
CONCLUSION: At the end of surgery, it is not the initial incision size alone but also the distortion of the incision during subsequent stages of surgery that determine the integrity of the CCI.
SETTING: Iladevi Cataract & IOL Research Centre, Ahmedabad, India.
DESIGN: Prospective randomized clinical trial.
METHODS: Eyes were randomized to have phacoemulsification using a 1.8 mm clear corneal incision (CCI) system (Group 1, Stellaris system) or a 2.2 mm CCI system (Group 2, Intrepid Infiniti system). Incision enlargement at end of surgery was measured. At the conclusion of surgery, trypan blue was applied over the conjunctival surface, anterior chamber aspirate withdrawn, and ingress into anterior chamber measured. Postoperative observations included evaluation of the CCI using anterior segment optical coherence tomography (AS-OCT), change in central corneal thickness (CCT), and anterior segment inflammation at 1 day, 1 week, and 1 month and endothelial cell loss and surgically induced astigmatism (SIA) at 3 months.
RESULTS: Incision enlargement (P<.001) and trypan blue ingress in the anterior chamber (mean 1.7 log units ± 0.6 [SD] versus 3.8 ± 0.6 log units, P<.001) was significantly greater in Group 1 (n = 50) than in Group 2 (n = 50). On AS-OCT, endothelial misalignment and gaping were more frequent in Group 1 at 1 day (P=.001) and 1 week (P=.018). There were no significant differences in SIA, change in CCT, endothelial cell loss, or anterior segment inflammation (P>.05).
CONCLUSION: At the end of surgery, it is not the initial incision size alone but also the distortion of the incision during subsequent stages of surgery that determine the integrity of the CCI.
Предметные рубрики MeSH
Aqueous HumorColoring AgentsCorneaCorneal Endothelial Cell LossDouble-Blind MethodFemaleHumansIntraoperative ComplicationsLens Implantation, IntraocularMaleMicrosurgeryMiddle AgedPhacoemulsificationPostoperative ComplicationsProspective StudiesSurgical Wound DehiscenceTomography, Optical CoherenceTreatment OutcomeTrypan BlueWound Healing