Abstract
BackgroundTo develop a side-view imaging technique for observing the dynamic behavior of posterior chamber structures (PCSs) in porcine eyes which mimics closed-eye cataract surgery in humans.MethodsEnucleated porcine eyes were placed into liquid nitrogen for 5 seconds and immediately bisected at about a 45-degree angle to the equatorial plane. The anterior portion was attached firmly to a glass slide with superglue and sprinkled with wheat flour. Phacoemulsification and aspiration (PEA) was performed as in humans on 10 consecutive porcine eyes. The movements of the PCSs were monitored through the glass slide with a high-resolution video camera set below the cut surface of the eye. The intraocular pressure (IOP) was monitored during the surgery. The highest IOP, operation time, and volume of irrigation fluid of 10 whole eyes were compared to that obtained from the bisected eyes glued to a glass slide. In a second set of experiments, the strength of the seal between the bisected eye and the glass slide was tested in three sets of eyes: 1) frozen eye fixed with superglue with wheat flour for 3 min; 2) frozen eye fixed with superglue for 3 min; and 3) non-frozen eye fixed with superglue for 30 min. The highest IOP that led to a disruption of the seal was compared among the three groups.ResultsPEA was successfully performed on 9 of 10 (90%) eyes with the movements of the PCSs clearly observed. The average maximum intraocular pressure of the 9 bisected eyes was 55.8 ± 4.7 mmHg and that for the 10 unbisected eyes was 55.3 ± 5.0 mmHg (P = 0.650). The frozen eye fixed with superglue in combination with wheat flour (Group 1) had the strongest sealing strength with an average IOP at the breaking point of 117.3 ± 36.2 mmHg.ConclusionsOur side-view imaging technique can be used to evaluate the changes of the PCSs during intraocular surgery and for surgical training of new residents.
Highlights
To develop a side-view imaging technique for observing the dynamic behavior of posterior chamber structures (PCSs) in porcine eyes which mimics closed-eye cataract surgery in humans
We have developed a new technique for examining the PCSs in postmortem porcine eyes
Because the preparation of the bisected eyes with both superglue and wheat flour (Group 1) was rapid and effective, and because the eyes could tolerate the fluctuations in the intraocular pressure (IOP) well, this method was used in all further experiments
Summary
To develop a side-view imaging technique for observing the dynamic behavior of posterior chamber structures (PCSs) in porcine eyes which mimics closed-eye cataract surgery in humans. Davis et al in 1990 [2], used postmortem human eyes and the preparation permitted real-time assessments of the intraoperative movements of the PCSs especially during the fixation of the intraocular lens. These methods have been widely used as research and educational tools to improve the quality and safety of PEA and cataract surgery. It enables the surgeon to observe only the lens and ciliary-zonular complex from the back of the eye, and this has limited the information on the behavior of the PCSs. In 1992, Assia and Apple developed an uveoscleral window technique in enucleated human eyes in which the lens and other PCSs could be seen by removing parts of the cornea, sclera, and ciliary body [3,4]. A monitoring of the intraocular pressure (IOP) during the surgery was not possible
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