Quantification of residual ophthalmic viscosurgical device after irrigation/aspiration in experimental cataract surgery in vitro

Abstract

To determine the distribution and quantity of ophthalmic viscosurgical device (OVD) retained in the lens capsular bag after irrigation/aspiration (I/A) in experimental cataract surgery. Department of Ophthalmology, Kashiwa Hospital, Jikei University School of Medicine, Japan. Experimental study. Fifteen freshly enucleated porcine eyes were used. Sodium hyaluronate 1.0% (Healon) was mixed with a fixed concentration of silica nanoparticles encapsulating fluorescein isothiocyanate (labeled OVD), and it was injected separately into the capsular bag and injector cartridge for intraocular lens (IOL) insertion. After a 3-piece IOL (YA-60BBR) or a 1-piece IOL (iSert 255) was implanted within the capsular bag, OVD was removed by thorough I/A. Eyes that were injected with the labeled OVD into the capsular bag without IOL insertion were used as controls. The distribution of residual OVD in the capsular bag was observed under ultraviolet irradiation using Miyake-Apple view. Then, the excised capsular bag was dissolved in hydrogen fluoride, and silica concentration was measured quantitatively by elemental analysis. The quantity of residual OVD in the capsular bag was 243.1μg±1.3 (SD) in the 3-piece IOL-implanted group, 383.8±11.1μg in the 1-piece IOL-implanted group, and 99.0±1.3μg in the control group. In the 1-piece IOL-implanted eyes, OVD in the form of clumps tended to remain near the center of the optic on the posterior side, and the quantity of residual OVD was significantly greater than in 3-piece IOL-implanted eyes (P<.05). The quantity of residual OVD after I/A could be determined indirectly using labeled OVD, and the quantity was significantly greater in 1-piece IOL-implanted eyes than in 3-piece IOL-implanted eyes.