The influence that ophthalmic viscosurgical device gives intra ocular pressure during small incision and ultra small incision cataract surgeries Takuya.

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The influence that ophthalmic viscosurgical device gives intra ocular pressure during small incision and ultra small incision cataract surgeries Takuya Shiba, Takako Torisu, Akiko Hayama Katsuya Mitooka, Hiroshi Tsuneoka Department of Ophthalmology Jikei University School of Medicine Tokyo, Japan The authors have no financial interest in the products mentioned in this poster

Objective Using the experimental model we originally prepared, we estimated the difference in the inner pressure of the anterior chamber filling a different type of ophthalmic viscosurgical devices (OVD) in hydrodissection during small incision and ultra small incision cataract surgeries.

Methods 1/3 We made the diameter of the top of the pipettes 1.5mm (micro bimanual phaco group), 2.4mm (micro coaxial phaco group), and 3.0mm (coaxial phaco group). 1.5mm 2.4mm 3.0mm

Methods 2/3 Filled the pipettes with OVD, and applied 5mmHg of constant pressure, using a pressure pump to imitate the process of hydrodissection, and then measured the inner pressure of the pipettes.

Methods 3/3 Used 4 types of OVD Low Viscosity Dispersive Opegan (Santen, Japan) Midium Viscosity Dispersive Viscoat (Alcon, USA). Viscous Cohesive Opegan Hi (Santen, Japan) Viscoadaptive Healon 5 (AMO, USA)

Results 1/2 3.0mm 2.4mm 1.5mm Coaxial Phaco Micro Coaxial Phaco 20 60 100 mmHg Opegan Opegan Hi Viscoat Healon 5 2.4mm Micro Coaxial Phaco 20 60 100 mmHg Opegan Opegan Hi Viscoat Healon 5 1.5mm Micro Bimanual Phaco 20 60 100 mmHg Opegan Opegan Hi Viscoat Healon 5

Results 2/2 The micro coaxial and micro bimanual groups have shown a difference in the inner pressure with Opegan and other OVDs that is greater than that of the coaxial group.

Discussion Intraocular Pressure / Incision Size (mm) Low Viscosity Dispersive (Opegan, etc) 3.0 ≈ 2.4 ≈ 1.5 Viscous Cohesive (Opegan Hi, etc) 3.0 ≈ 2.4 < 1.5 Midium Viscosity Dispersive (Viscoat, etc) 3.0 ≈ 2.4 <<1.5 Viscoadaptive (Healon 5, etc) 3.0 < 2.4 <<<1.5

Conclusion Our results suggested the necessity of selecting a low-molecular dispersive type of ophthalmic viscosurgical device for anterior capsulotomy when we implement small-incision and micro-incision cataract surgeries.