Effect of Anterior Chamber Instability during Phacoemulsification Combined with Intraocular Lens Implantation

Purpose. To determine the incidence of anterior chamber (AC) instability during phacoemulsification (phaco) combined with intraocular lens implantation and investigate its effect on intraocular tissues. Methods. Among the 248 enrolled eyes, 121 and 127 eyes were categorized into the irrigation and n...

Full description

Saved in:
Bibliographic Details
Main Authors: Wenjing Geng, Wenli Lin, Pei Song, Min Zhang, Jian Wu, Shu Su, Yurong Yuan, Min Ji, Huaijin Guan
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2022/2848565
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832565526437560320
author Wenjing Geng
Wenli Lin
Pei Song
Min Zhang
Jian Wu
Shu Su
Yurong Yuan
Min Ji
Huaijin Guan
author_facet Wenjing Geng
Wenli Lin
Pei Song
Min Zhang
Jian Wu
Shu Su
Yurong Yuan
Min Ji
Huaijin Guan
author_sort Wenjing Geng
collection DOAJ
description Purpose. To determine the incidence of anterior chamber (AC) instability during phacoemulsification (phaco) combined with intraocular lens implantation and investigate its effect on intraocular tissues. Methods. Among the 248 enrolled eyes, 121 and 127 eyes were categorized into the irrigation and nonirrigation groups, respectively, depending on the use of a self-made anterior chamber maintainer (ACM) during phaco. AC stability was evaluated using operating microscopy and intraoperative optical coherence tomography (iOCT). Slit-lamp examination of AC flare and cells was performed 1 day postoperatively. Corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), central corneal thickness (CCT), posterior vitreous detachment (PVD), and central foveal thickness (CFT) were evaluated preoperatively and at 1 week, 1 month, and 3 months postoperatively. Results. There was good consistency in AC stability evaluation between operating microscopy and iOCT. The incidence of AC instability was significantly different between groups after the phaco and irrigation/aspiration tips were withdrawn from the AC P<0.001. At 1 day postoperatively, after excluding eyes in which the AC could not be visualized, AC cell grades were significantly lower in the irrigation group (P = 0.014). There was no significant difference in CDVA, IOP, ECD, and CCT between groups during the 3-month follow-up P>0.05. At 1 month and 3 months postoperatively, PVD occurred in 8 (16.3%) and 14 (28.6%) eyes and in 22 (40.7%) and 37 (68.5%) eyes in the irrigation and nonirrigation groups, respectively (P = 0.006 and P<0.001). CFT was significantly higher in the nonirrigation group at 1 and 3 months postoperatively (P = 0.018 and P = 0.010). Conclusions. Both operating microscopy and iOCT are efficient for AC stability evaluation. When the phaco and I/A tips were withdrawn from the AC, there was frequent instability. Intraoperative AC instability can increase surgery-induced inflammation and lead to postoperative complications such as PVD, retinal detachment, and macular edema. The self-made ACM can effectively reduce the incidence of intraoperative AC instability and these complications.
format Article
id doaj-art-b57d79c7b79f4338af8ae75107c5892c
institution Kabale University
issn 2090-0058
language English
publishDate 2022-01-01
publisher Wiley
record_format Article
series Journal of Ophthalmology
spelling doaj-art-b57d79c7b79f4338af8ae75107c5892c2025-02-03T01:07:29ZengWileyJournal of Ophthalmology2090-00582022-01-01202210.1155/2022/2848565Effect of Anterior Chamber Instability during Phacoemulsification Combined with Intraocular Lens ImplantationWenjing Geng0Wenli Lin1Pei Song2Min Zhang3Jian Wu4Shu Su5Yurong Yuan6Min Ji7Huaijin Guan8Eye InstituteEye InstituteEye InstituteEye InstituteEye InstituteEye InstituteEye InstituteEye InstituteEye InstitutePurpose. To determine the incidence of anterior chamber (AC) instability during phacoemulsification (phaco) combined with intraocular lens implantation and investigate its effect on intraocular tissues. Methods. Among the 248 enrolled eyes, 121 and 127 eyes were categorized into the irrigation and nonirrigation groups, respectively, depending on the use of a self-made anterior chamber maintainer (ACM) during phaco. AC stability was evaluated using operating microscopy and intraoperative optical coherence tomography (iOCT). Slit-lamp examination of AC flare and cells was performed 1 day postoperatively. Corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), central corneal thickness (CCT), posterior vitreous detachment (PVD), and central foveal thickness (CFT) were evaluated preoperatively and at 1 week, 1 month, and 3 months postoperatively. Results. There was good consistency in AC stability evaluation between operating microscopy and iOCT. The incidence of AC instability was significantly different between groups after the phaco and irrigation/aspiration tips were withdrawn from the AC P<0.001. At 1 day postoperatively, after excluding eyes in which the AC could not be visualized, AC cell grades were significantly lower in the irrigation group (P = 0.014). There was no significant difference in CDVA, IOP, ECD, and CCT between groups during the 3-month follow-up P>0.05. At 1 month and 3 months postoperatively, PVD occurred in 8 (16.3%) and 14 (28.6%) eyes and in 22 (40.7%) and 37 (68.5%) eyes in the irrigation and nonirrigation groups, respectively (P = 0.006 and P<0.001). CFT was significantly higher in the nonirrigation group at 1 and 3 months postoperatively (P = 0.018 and P = 0.010). Conclusions. Both operating microscopy and iOCT are efficient for AC stability evaluation. When the phaco and I/A tips were withdrawn from the AC, there was frequent instability. Intraoperative AC instability can increase surgery-induced inflammation and lead to postoperative complications such as PVD, retinal detachment, and macular edema. The self-made ACM can effectively reduce the incidence of intraoperative AC instability and these complications.http://dx.doi.org/10.1155/2022/2848565
spellingShingle Wenjing Geng
Wenli Lin
Pei Song
Min Zhang
Jian Wu
Shu Su
Yurong Yuan
Min Ji
Huaijin Guan
Effect of Anterior Chamber Instability during Phacoemulsification Combined with Intraocular Lens Implantation
Journal of Ophthalmology
title Effect of Anterior Chamber Instability during Phacoemulsification Combined with Intraocular Lens Implantation
title_full Effect of Anterior Chamber Instability during Phacoemulsification Combined with Intraocular Lens Implantation
title_fullStr Effect of Anterior Chamber Instability during Phacoemulsification Combined with Intraocular Lens Implantation
title_full_unstemmed Effect of Anterior Chamber Instability during Phacoemulsification Combined with Intraocular Lens Implantation
title_short Effect of Anterior Chamber Instability during Phacoemulsification Combined with Intraocular Lens Implantation
title_sort effect of anterior chamber instability during phacoemulsification combined with intraocular lens implantation
url http://dx.doi.org/10.1155/2022/2848565
work_keys_str_mv AT wenjinggeng effectofanteriorchamberinstabilityduringphacoemulsificationcombinedwithintraocularlensimplantation
AT wenlilin effectofanteriorchamberinstabilityduringphacoemulsificationcombinedwithintraocularlensimplantation
AT peisong effectofanteriorchamberinstabilityduringphacoemulsificationcombinedwithintraocularlensimplantation
AT minzhang effectofanteriorchamberinstabilityduringphacoemulsificationcombinedwithintraocularlensimplantation
AT jianwu effectofanteriorchamberinstabilityduringphacoemulsificationcombinedwithintraocularlensimplantation
AT shusu effectofanteriorchamberinstabilityduringphacoemulsificationcombinedwithintraocularlensimplantation
AT yurongyuan effectofanteriorchamberinstabilityduringphacoemulsificationcombinedwithintraocularlensimplantation
AT minji effectofanteriorchamberinstabilityduringphacoemulsificationcombinedwithintraocularlensimplantation
AT huaijinguan effectofanteriorchamberinstabilityduringphacoemulsificationcombinedwithintraocularlensimplantation