B.MALYUGIN MD,PhD A.GOLOVIN MD

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Presentation transcript:

B.MALYUGIN MD,PhD A.GOLOVIN MD ANTERIOR SEGMENT OCT OF CLEAR CORNEAL INCISIONS AFTER 1.8mm CMICS AND 2.8mm SANDARD COAXIAL CATARACT SURGERY B.MALYUGIN MD,PhD A.GOLOVIN MD S.FYODOROV EYE MICROSURGERY COMPLEX STATE INSTITUTION MOSCOW, RUSSIA Ekaterinburg Cheboksary Krasnodar Moscow St.-Petersburg Kaluga Khabarovsk Volgograd Novosibirsk Irkutsk Tambov Orenburg FINANCIAL DISCLOSURE B.MALYUGIN – Bausch & Lomb Surgical, MST A. GOLOVIN – Nothing to disclose

PURPOSE TO COMPARE THE STRUCTURE OF THE CLEAR CORNEAL TUNNELS DONE FOR THE 1.8 mm C-MICS AND 2.8 mm STANDARD CO-AXIAL PHACO USING THE ANTERIOR SEGMENT OCT

MATERIALS & METHODS I-st GROUP: 20 EYES (20 PATIENTS) 1.8 mm C-MICS with AKREOS MI60 IOL II-nd GROUP: 20 EYES (20 PATIENTS) 2.8 mm SICS with AKREOS AO IOL 3

DUAL LINEAR FOOTPEDAL CONTROL MATERIALS & METHODS PHACO SETTINGS QUICK CHOP IV POLE HEIGHT - 100 cm DUAL LINEAR FOOTPEDAL CONTROL US POWER LINEAR 30% (max) 80 PPS, 50% DC VACUUM RISE TIME – 2 US - 400 mmHg I/A - 600 mmHg

MATERIALS & METHODS EVALUATION PARAMETERS: CORNEAL THICKNESS, INCISION LENGTH, ANGLE OF INCISION EVALUATION INTERVALS: 1 DAY, 1 WEEK, 2 WEEKS, 4 WEEKS POSTOP 5

DESCEMET MEMBRANE DETACHMENT ENDOTHELIAL SIDE MISALIGNMENT RESULTS CCI ARCHITECTURE INTERNAL WOUND ASPECT 1.8 mm C-MICS (n=20) 2.8 mm SICS ENDOTHELIAL GAPING 5 6 DESCEMET MEMBRANE DETACHMENT 11 10 ENDOTHELIAL SIDE MISALIGNMENT 8 7 6

CORNEAL THICKNESS DYNAMICS RESULTS CORNEAL THICKNESS DYNAMICS EVALUATION INTERVALS CORNEAL THICKNESS (microns) 1.8 mm C-MICS 2.8 mm SICS 1st day POSTOP 1.26 ±0.11 1.06 ±0.10 1st week POSTOP 0.86 ±0.05 0.95 ±0.08 2nd week POSTOP 0.80 ±0.04 0.79 ±0.07 4th week POSTOP 0.79 ±0.06 0.81 ±0.05 7

INCISION ANGLE vs CORNEAL THICKNESS CHANGES RESULTS INCISION ANGLE vs CORNEAL THICKNESS CHANGES (1st day POSTOP) 1.8 mm C-MICS 2.8 mm SICS ANGLE OF INCISION (degrees) 18.65 ± 1.56 23.38 ± 1.35 19.36 ± 1.48 23.76 ± 1.00 CORNEAL THICKNESS (mm) 1.16± 0.03 1.35± 0.04 1.02± 0.06 1.11± 0.11 8

CONCLUSIONS THERE IS NO SIGNIFICANT DIFFERENCE BETWEEN 1.8 mm and 2.8 mm GROUPS IN ENDOTHELIAL MISALIGNMENT AND DESCEMET MEMBRANE DEFECTS THE PATTERN OF STROMAL HYDRATION IN POSTOPERATIVE PERIOD DIFFERS WITH THE SIZE OF THE INCISION CORNEAL EDEMA AT THE 1ST POSTOP DAY IN 1.8 mm GROUP IS MORE SIGNIFICANT BUT IT’S RESOLUTION HAS A TENDENCY TO OCCUR EARLIER THAN IN 2.8 mm GROUP INCISIONS WITH SHARPER ANGLE OF ATTACK (19 vs 24 deg.) IN BOTH 1.8 mm and 2.8 mm GROUPS WERE FOLLOWED BY LESS STROMAL HYDRATION AND QUICKER CORNEAL THICKNESS RECOVERY

THANK YOU FOR YOUR ATTENTION Boris MALYUGIN MD, PhD Andrei GOLOVIN MD Ekaterinburg Cheboksary Krasnodar Moscow St.-Petersburg Kaluga Khabarovsk Volgograd Novosibirsk Irkutsk Tambov Orenburg