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Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla, Mèxico. Poster for ASCRS, San Francisco, 2009. No Finantial Interest
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Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Jan 02, 2016

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Page 1: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Spending 40 cc in an entire Cataract Surgery. Comparative study.

Arturo Pèrez-Arteaga M.D.Medical Director & FounderCentro Oftalmològico Tlalnepantla, Mèxico.Poster for ASCRS, San Francisco, 2009.

No Finantial Interest

Page 2: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Background

Currently Micro-Incisional Cataract Surgery Techniques are gaining field against traditional ones.

Both, Micro-Coaxial & Micro-Biaxial are showing advantages in particular in fluidics.

A debate exist between promoters of each technique regarding the advantages and disadvantages.

Page 3: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Objective & Type of Study

To determine which Micro-Incisional Cataract Technique utilizes less amount of irrigation inside the eye.

Comparative, prospective, randomized study between Micro-Coaxial & Micro-Biaxial techniques.

Page 4: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Material & Methods

50 eyes of uncomplicated senile cataract were operated by the same surgeon and divided in two randomized groups.

25 were operated with Micro-Coaxial technique (1.6 mm incision); Oertli Phaco System and passive infusion.

25 were operated with Micro-Biaxial technique (0.7 mm incision); Accurus Phaco System and forced infusion.

The amount of total Intraocular Saline Solution was measured in all cases, and both groups were compared.

Page 5: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Forced Infusion

Internal Forced Infusion created with the Accurus Surgical System

Active irrigation through a 25G cannula

Page 6: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Results

The Micro-Coaxial group used an average of 69 cc in the entire procedure.

The Micro-Biaxial group used an average of 42 cc in the entire procedure, including I/A.

Page 7: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Results

The Micro-Incisional Technique that utilizes less amount of Intraocular Solution during the entire surgery was Micro-Coaxial

The differente has statistical significance.

Page 8: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Results

Bottle starting a Micro-Biaxial case Bottle ending the same case.

Page 9: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Discussion

As much as the amount of infusion is lower in the anterior chamber, less trauma over the endothelial cells is obtained.

Page 10: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

Discussion

Further studies are needed to determine the exact significance of less irrigating volume in the postoperative state of the cornea.

Page 11: Spending 40 cc in an entire Cataract Surgery. Comparative study. Arturo Pèrez-Arteaga M.D. Medical Director & Founder Centro Oftalmològico Tlalnepantla,

References

Agarwal A. Agarwal A. et al. Phakonit phacoemulsification trough a 0.9 mm corneal incision. J Cataract Refract. Surg. 2001;27:1548-1552.

Agarwal A. Agarwal A. et al. Phakonit: Lens removal trough a 0.9 mm incision. J Cataract Refract Surg. 2001;27:1531-1532.

Agarwal A. Agarwal S. Agarwal A. Phakonit and laser phakonit: lens removal trough a 0.9-mm incision. Phacoemulsification, laser cataract surgery and foldable IOL´s. New Delhi, India: Jaypee; 2000; 204-216.

Tsuneoka H. Shiba T.Feasibility of ultrasound cataract surgery trough a 1.4 mm incision. Journal Cataract and Refractive Surgery, 2001; 27, 934-940.

Agarwal, Amar. Bimanual 0.9 mm approach to phaco promises astigmatic neutral cataract surgery and faster rehabilitation. Eurotimes, February 2003.

Alió, Jorge. MICS ready to go. Ocular Surgery News, March, 2003. Pérez-Arteaga, Arturo. Accurus Forced Infusión good for MICS. Ocular Surgery

News, 6/15/03. Pérez-Arteaga, Arturo. Bottle Infusión Tool of the Millennium Surgical System

for Phakonit. Ocular Surgery News; 09/15/03. Pérez-Arteaga, Arturo. Anterior Vented Gas Forced Infusion of the Accurus

Surgical System for Phakonit. J Cataract Refract Surg. April 2004. Pèrez-Arteaga, Arturo. Step by Step to Biaxial Lens Surgery. Jaypee Bros.

Publishers. India, 2008.