J Korean Ophthalmol Soc.  2013 Jan;54(1):60-64. 10.3341/jkos.2013.54.1.60.

The Effects of Conjunctival Shield on Pain Alleviation During Cataract Surgery in Conjunctivochalasis Patients

• Seo HW
• Choi SK
• Lee DH
• Kim JH

• KMID: 2216450
• DOI: http://doi.org/10.3341/jkos.2013.54.1.60

Abstract

PURPOSE
To evaluate the effect of conjunctival shield on pain alleviation during cataract surgery in conjunctivochalasis patients for conjunctiva drawn into speculum suction holes during cataract surgery.
METHODS
Forty patients with conjunctivochalasis undergoing cataract surgery using un aspirating speculum were evaluated in the present study. A thin piece of surgical wipe (conjunctival shield) was inserted between the lid and bulbar conjunctiva to shield the conjunctiva from the suction hole and thereby prevent it from being sucked into the hole. Additionally, patients were asked to rank pain following speculum placement both before and after conjunctiva shield insertion by visual analogue scale.
RESULTS
The pain scores were 2.50 +/- 0.78 points before conjunctival shield insertion, and 1.25 +/- 0.66 points after conjunctival shield insertion, which was a significant decrease (p = 0.01). In addition, the results showed a 70% reduction in pain following shield insertion.
CONCLUSIONS
Conjunctivochalasis causes pain during cataract surgery when using an aspirating speculum. The conjunctival shield insertion is a safe and simple method for pain-free cataract surgery in conjunctivochalasis patients.

Keyword

Cataract surgery; Conjunctivochalasis; Pain control

MeSH Terms

Cataract*
Conjunctiva
Humans
Suction
Surgical Instruments
United Nations

Figure

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  Figure 1. Lieberman Temporal Aspiration speculum – Six ports on each blade allow continuous aspiration.

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  Figure 2. (A) After opening the eyelids using a aspiration speculum, the redundant conjunctiva is drawn into the suction hole of the speculum (black arrow: redundant conjunctiva sucked into the inferotemporal suction hole). (B) A piece of surgical wipe is cut to the appropriate size and shape to create a conjunctival shield. (C) The shield is inserted between the lid and bulbar conjunctiva directly beneath the suction hole of the speculum (black arrows). (D) The surgical wipe prevents conjunctiva from being drawn into the suction hole during cataract surgery (black arrow).

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  Figure 3. Patient was asked to check the degree of subjective pain using modified visual analogue scale.

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  Figure 4. The effect of the conjunctival shield on pain scores. Shield insertion resulted in reduction in pain scores in 28 eyes (70%).

Reference

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