Post-occlusion surge parameters during ex vivo phacoemulsification with a new method of adaptive infusion control
https://doi.org/10.21516/2072-0076-2024-17-3-79-84
Abstract
A new method of adaptive control of infusion during phacoemulsification (PE) based on the Optimed Profi (Optimedservice) surgical system was developed, allowing calculation of the predicted volume of post-occlusion surge (POS) by monitoring aspiration and infusion flow rates. Purpose. To compare POS amplitude, predicted and actual volumes of POS during experimental ex vivo PE on cadaveric porcine eyes, between Optimed Profi and Centurion Vision surgical systems. Material and methods. For two experimental PE series of 10 operations on porcine eyes, the mean POS amplitude (mm Hg) was measured using a pressure sensor in the anterior eye chamber. Predicted and actual POS volumes were assessed using a non-contact aspiration-line flowmeter sensor by varying aspiration flow rate depending on the phaco needle patency. The parameters were compared between the series using the Student t-test. Results. The mean POS amplitude during PE by Optimed Profi and Centurion Vision System was 12.10 ± 0.21 and 13.3 ± 0.3 mm Hg, respectively (p < 0.001). The mean value of the predicted POS volume during PE by Optimed Profi and Centurion Centurion Vision System was 136.80 ± 9.59 and 146.00 ± 9.46 μm, respectively (p > 0.01). The mean value of the actual POS volume during PE by Optimed Profi and Centurion Vision System was 135.30 ± 4.97 and 158.50 ± 8.63 μm, respectively (p < 0.01). Conclusion. The lower values of POS amplitude and predicted and actual volumes of POS in the series using the new method of adaptive infusion control may indicate a better hydrodynamic stability in experimental PE.
About the Authors
B. M. AznabaevRussian Federation
Bulat M. Aznabaev — Dr. of Med. Sci., professor, professor of chair of ophthalmology with postgraduate course, Bashkir State Medical University; general director, Optimedservis Ltd.
3, Lenin St., 450008, Ufa; 8, 50 let SSSR St., 450059, Ufa
T. R. Mukhamadeev
Russian Federation
Timur R. Mukhamadeev — Dr. of Med. Sci., head of chair of ophthalmology with postgraduate course, Bashkir State Medical University; deputy general director for scientific and clinical work, Optimedservis Ltd.
3, Lenin St., 450008, Ufa; 8, 50 let SSSR St., 450059, Ufa
T. I. Dibaev
Russian Federation
Tagir I. Dibaev — Cand. of Med. Sci., associate professor of chair of ophthalmology with postgraduate course, Bashkir State Medical University; head of research coordination department, Optimedservis Ltd.
3, Lenin St., 450008, Ufa; 8, 50 let SSSR St., 450059, Ufa
T. N. Ismagilov
Russian Federation
Timur N. Ismagilov — PhD student of Department of chair of Ophthalmology with Postgraduate course, Bashkir State Medical University; junior researcher of research coordination department, Optimedservis Ltd.
3, Lenin St., 450008, Ufa; 8, 50 let SSSR St., 450059, Ufa
References
1. Suzuki H, Igarashi T, Takahashi H. Effect of a new phacoemulsification and aspiration handpiece on anterior chamber stability. J Cataract Refract Surg. 2023; 49 (1): 91–6. doi: 10.1097/j.jcrs.0000000000001071
2. Sharif-Kashani P, Fanney D, Injev V. Comparison of occlusion break responses and vacuum rise times of phacoemulsification systems. BMC Ophthalmol. 2014; 14 (1): 1–7. doi: 10.1186/1471-2415-14-96
3. Packer M, Fishkind WJ, Fine IH, Seibel BS, Hoffman RS. The physics of phaco: a review. J Cataract Refract Surg. 2005 Feb; 31 (2): 424–31. doi: 10.1016/j.jcrs.2004.11.027
4. Vasavada V, Vasavada AR, Vasavada VA, Vasavada SA, Bhojwani D. Real-time dynamic changes in intraocular pressure after occlusion break: comparing 2 phacoemulsification systems. J Cataract Refract Surg. 2021 Sep 1; 47 (9): 1205–9. doi: 10.1097/j.jcrs.0000000000000666
5. Benjamin L. Fluidics and rheology in phaco surgery: What matters and what is the hype? Eye. Nature Publishing Group. 2018; 32 (2): 204–9. doi: 10.1038/eye.2017.299
6. Thorne A, Dyk DW, Fanney D, et al. Phacoemulsifier occlusion break surge volume reduction. J Cataract Refract Surg United States. 2018; 44 (12): 1491–6. doi: 10.1016/j.jcrs.2018.01.032
7. Miller KM, Dyk DW, Yalamanchili S, et al. Experimental study of occlusion break surge volume in 3 different phacoemulsification systems. J Cataract Refract Surg United States. 2021; 47 (11): 1466–72. doi: 10.1097/j.jcrs.0000000000000651
8. Zhou J, Han D. Post-occlusion surge and anterior chamber stability in a new phacoemulsification machine with small-bore, dual-durometer aspiration tubing. Invest Ophthalmol Vis Sci. 2021; 62 (8): 574. https://iovs.arvojournals.org/article.aspx?articleid=2774553
9. Kunishige T, Takahashi H. Effects of combinations of ophthalmic viscosurgical devices and suction flow rates on the corneal endothelial cell damage incurred during phacoemulsification. J Ophthalmol. 2020; 2020: 2159363. doi: 10.1155/2020/2159363
10. Aznabaev B.M., Mukhamadeev T.R., Bikchuraev D.R., Dibaev T.I., Makhmutov V.F. Microcollapses of the anterior chamber during ultrasound phacoemulsification. Meditsinsky Vestnik Bashkortostana. 2014; 9 (2): 85–8 (In Russ.).
11. Zacharias J, Zacharias S. Volume-based characterization of postocclusion surge. J Cataract Refract Surg. 2005; 31 (10): 1976–82. doi: 10.1016/j.jcrs.2005.03.061
12. Dyk DW, Miller KM. Mechanical model of human eye compliance for volumetric occlusion break surge measurements. J Cataract Refract Surg. 2018; 44 (2): 231–6. doi: 10.1016/j.jcrs.2017.10.052
13. Aravena C, Dyk D, Thorne A, et al. Aqueous volume loss associated with occlusion break surge in phacoemulsifiers from 4 different manufacturers. J Cataract Refract Surg. ASCRS and ESCRS. 2018; 44 (7): 884–8. doi: 10.1016/j.jcrs.2018.02.026
14. Aznabaev B.M., Dibaev T.I., Mukhamadeev T.R., Ismagilov T.N. Method of adaptive infusion management during phacoemulsification. RF Patent No. 2788289, 17. 01. 2023 (In Russ.).
15. Gordon R, Ranch L. Pressure control in phacoemulsification system. U.S. patent № 9119701; 2015.
16. Solomon KD, Lorente R, Fanney D, Cionni RJ. Clinical study using a new phacoemulsification system with surgical intraocular pressure control. J Cataract Refract Surg. 2016 Apr; 42 (4): 542–9. doi: 10.1016/j.jcrs.2016.01.037
17. Machuk RW, Arora S, Kutzner M, et al. Porcine cataract creation using formalin or microwave treatment for an ophthalmology wet lab. Can J Ophthalmol. 2016; 51 (4): 244–8. doi: 10.1016/j.jcjo.2016.01.012
18. Van Vreeswijk H, Pameyer JH. Inducing cataract in postmortem pig eyes for cataract surgery training purposes. J Cataract Refract Surg United States. 1998; 24 (1): 17–8. doi: 10.1016/s0886-3350(98)80068-0
Review
For citations:
Aznabaev B.M., Mukhamadeev T.R., Dibaev T.I., Ismagilov T.N. Post-occlusion surge parameters during ex vivo phacoemulsification with a new method of adaptive infusion control. Russian Ophthalmological Journal. 2024;17(3):79-84. (In Russ.) https://doi.org/10.21516/2072-0076-2024-17-3-79-84