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Irrigation dynamic pressure-assisted hydrodissection during cataract surgery

Authors Masuda Y, Iwaki H, Kato N, Takahashi G, Oki K, Tsuneoka H

Received 12 October 2016

Accepted for publication 28 December 2016

Published 14 February 2017 Volume 2017:11 Pages 323—328

DOI https://doi.org/10.2147/OPTH.S124528

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Supplementary video of iH during phacoemulsification cataract surgery.

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Yoichiro Masuda,1 Hisaharu Iwaki,2 Noriko Kato,1 Genichiro Takahashi,1 Kotaro Oki,3 Hiroshi Tsuneoka4

1Department of Ophthalmology, The Jikei University, Katsushika Medical Center, 2Iwaki Eye Clinic, 3Oki Eye Surgery Center, 4Department of Ophthalmology, The Jikei University, School of Medicine, Tokyo, Japan

Abstract: The irrigation dynamic pressure-assisted hydrodissection technique (irrigation-hydro [iH]) does not require performing manual hydrodissection using a syringe and cannula to achieve cortical-capsular cleavage during cataract surgery. Since the iH technique uses the phaco tip to intentionally vacuum the intraocular fluid in order to induce the irrigation dynamic pressure for cortical-capsular cleavage, there is a reduction in the intraocular pressure (IOP) from the bottle-height-dependent hydrostatic pressure. Thus, since the peak irrigation pressure derived from the phaco tip sleeve will be limited by the height of the irrigation fluid bottle, this is advantageous in helping to avoid excessively high IOP during cortical-capsular hydrodissection. Using this technique, we were able to effectively perform phacoemulsification without complications in 607 of 609 cataract eyes. Our findings show that utilization of the iH technique would be of benefit to patients, as it prevents high-pressure hydrodissection-related complications, such as capsular block syndrome and tears in the anterior hyaloid membrane during cataract surgery.

Keywords: cataract surgery, hydrodissection, irrigation pressure, hydrodissection-related complication, capsular block syndrome, anterior hyaloid membrane tear, FLACS

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Use of the phaco tip technique for lens cleavage and removal during cataract surgery

Masuda Y, Oki K, Iwaki H, Okamoto T, Tsuneoka H

Clinical Ophthalmology 2016, 10:1925-1929

Published Date: 6 October 2016