Korean J Ophthalmol.  2011 Feb;25(1):15-21. 10.3341/kjo.2011.25.1.15.

Comparison of OVD and BSS for Maintaining the Anterior Chamber during IOL Implantation

• Lee HY
• Choy YJ
• Park JS

• KMID: 994406
• DOI: http://doi.org/10.3341/kjo.2011.25.1.15

Abstract

PURPOSE
To compare surgical results between conventional intraocular lens (IOL) implantation using an ophthalmic viscosurgical device (OVD) and IOL implantation using a balanced salt solution (BSS) after irrigation/aspiration (I/A) of the lens cortex.
METHODS
A randomized prospective study was conducted on 62 patients who underwent cataract surgery. Following completion of conventional I/A of the lens cortex, we divided patients into two groups according to whether or not BSS was used. In group A (n = 31), the anterior chamber and the capsular bag were completely filled with an OVD before IOL implantation. On the other hand, in group B (n = 31), BSS was irrigated into the anterior chamber through a previous side port during IOL implantation. Surgical results were compared between the two groups.
RESULTS
In both groups, IOP peaked six hours after surgery. The occurrence of an IOP spike by postoperative day one was observed in six cases (6 / 31) in group A and in no cases (0 / 31) in group B, a difference that was statistically significant (p = 0.024). The values of endothelial cell density, central corneal thickness, anterior chamber inflammation, myopic shift, and posterior capsule opacification were not significantly different between the two groups.
CONCLUSIONS
Compared with the use of OVD for IOL implantation, use of BSS during IOL implantation resulted in reductions in postoperative IOP spike and OVD removal time.

Keyword

Balanced salt solution; Endothelial cell density; Intraocular pressure spike; Ophthalmic viscosurgical device

MeSH Terms

Aged
Anterior Chamber/*surgery
Cataract Extraction
Device Removal
Humans
Intraocular Pressure
Lens Implantation, Intraocular/*methods
Middle Aged
Phacoemulsification/*instrumentation/*methods
Prospective Studies
Therapeutic Irrigation/*methods

Figure

• 

  Fig. 1 (A) Following irrigation/aspiration of the cortex, the anterior chamber is irrigated with balanced salt solution (BSS) through a side port using a 27-gauge Amvisc Plus needle before intraocular lens implantation. (B) Insertion of the intraocular lens into the capsular bag while the anterior chamber is maintained with BSS.

• 

  Fig. 2 The change in mean intraocular pressure (IOP) over time. In both groups, IOP peaked six hours after surgery, with a mean of 21.43 ± 6.41 mmHg in group A and 17.41 ± 5.12 mmHg in group B. The difference between the two groups was significant (p = 0.034). IOP then showed a gradual decrease to preoperative levels by seven days postoperative.

• 

  Fig. 3 Assessment of the facilitation of intraocular lens implantation. In group A, the ratings 'good', 'average', and 'poor' were assigned in 87% (27 / 31), 13% (4 / 31), and 0% (0 / 31) of cases, respectively, while those in group B were 74% (23 / 31), 26% (8 / 31), and 0% (0 / 31) (p = 0.202 according to the Mann-Whitney U-test).

• 

  Fig. 4 Mean ophthalmic viscosurgical device removal time was 50.42 ± 3.83 seconds in group A and 8.29 ± 4.40 seconds in group B, illustrating that the time to complete removal of Amvisc Plus was significantly less in group B (p ≤ 0.001 according to the Mann-Whitney U-test).

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