Endothelial protection: Avoiding air bubble formation at the phacoemulsification tip
- 1 March 2002
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Cataract & Refractive Surgery
- Vol. 28 (3), 531-537
- https://doi.org/10.1016/s0886-3350(01)01155-5
Abstract
To investigate the conditions under which bubbles form during phacoemulsification. Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. In the first part of the study, the partial pressure of oxygen (pO(2)) was used as a surrogate measure for the partial pressure of air. Irrigation solutions packaged in glass and plastic containers were studied. A directly vented glass bottle was also tested. The pO(2) of the various irrigation solutions was measured as the containers were emptied. In the second part, phacoemulsification procedures were performed in rabbit eyes with different power settings and different irrigation solutions. Intracameral bubble formation during the procedure was recorded. Following the phacoemulsification procedures, the corneas were stained for F-actin and examined for endothelial injury. The initial pO(2) in irrigation solutions packaged in glass bottles was about half that at atmospheric levels; in solutions packaged in plastic, it was at atmospheric levels. As irrigation solutions were drained from the container, the pO(2) of the solution tended to rise toward atmospheric levels. The rate of pO(2) increase was markedly reduced by using a directly vented glass bottle. In the phacoemulsification procedures, bubble formation was most likely to occur with higher pO(2) and higher power settings. Observation of bubbles by the surgeon was highly correlated with endothelial damage. Keeping the pO(2) low reduced the risk of endothelial damage, especially at higher phacoemulsification powers. The packaging of irrigation solutions was the most important factor in controlling the initial pO(2) of the solution. The pO(2) can be minimized throughout a phacoemulsification procedure by using a directly vented glass bottle.Keywords
This publication has 5 references indexed in Scilit:
- Corneal Endothelial Damage by Air Bubbles During PhacoemulsificationAmerican Journal of Ophthalmology, 1997
- Cell density dependence of the ultrasonic degassing of fixed erythrocyte suspensionsJapanese Journal of Clinical Oncology, 1993
- Corneal Endothelial Cytoskeletal Changes in F-Actin With Aging, Diabetes, and After Cytochalasin ExposureAmerican Journal of Ophthalmology, 1992
- Protective effects of Healon and Occucoat against air bubble endothelial damage during ultrasonic agitation of the anterior chamberJournal of Cataract & Refractive Surgery, 1991
- Air bubble endothelial damage during phacoemulsification in human eye bank eyes: The protective effects of Healon and ViscoatJournal of Cataract & Refractive Surgery, 1990