The eye wash technique: A simple and effective technique for intraoperative ocular surface lavage

Abstract

Objectives: The author proposes an extremely effective and practical method of ocular surface hydrating and cleaning during anterior segment surgery, the Eye Wash Technique (EWT), in substitution for the traditional methods employing a syringe and cannula for ocular irrigation. Materials and Methods: The EWT utilizes the intraocular irrigating solution (IS) used in the surgery. It is performed by employing the irrigating line of the phacoemulsification (phaco) machine or the irrigating fluid IV drip in case of manual cataract surgery. The eye irrigation is performed directly from the Luer end attachment of these irrigating lines, which is positioned above the inner cantus pointing to the globe’s nasal limbal region. With the phaco machine pedal in position 1 (irrigation only) or in panel continuous irrigation mode in case of phaco surgery, or by opening the roller clamp of the IV drip line in case of manual surgery, IS flow ensues and is directed to the eye from a nasal direction to provide a steady flow to wash the exposed eye surface as well as the lid margins and lid speculum. The irrigation is maintained for two to five seconds with side-to-side jiggling if needed, to ensure complete ocular surface coverage. Cornea hydration is achieved and any unwanted material on the ocular surface is washed out. Results: The EWT was easily incorporated into the surgical routine with no difficulty in adaptation to the technique or in its employment. The surgical time was not prolonged when employing the technique. The EWT effectively provided both corneal hydration and ocular surface cleaning every time it was used, with no need to resort to the traditional syringe and cannula irrigation method at any time. Conclusion: The EWT should be incorporated into the anterior segment surgical routine and performed at the beginning of surgery, before inserting the intraocular lens, and at the end of the surgery; also, at any time during surgery should the need arise, enhancing anterior segment surgical visualization and safety.