J Korean Ophthalmol Soc.  2016 Oct;57(10):1555-1562. 10.3341/jkos.2016.57.10.1555.

Incidence of Posterior Capsular Opacification Based on Low and High Fluid-dynamic Parameters

• Na YH
• Shin JY
• Lee JH
• Kim JH
• Lee DH

• KMID: 2355410
• DOI: http://doi.org/10.3341/jkos.2016.57.10.1555

Abstract

PURPOSE
To compare the incidence of posterior capsular opacification (PCO) based on low and high fluid-dynamic parameters during cataract surgery and evaluate the importance of these findings.
METHODS
This retrospective study included 125 eyes in 73 patients with senile cataract who received a cataract surgery between September 2013 and March 2014. Patients were divided into 2 groups: those with low (vacuum: 180 mm Hg, aspiration flow: 18 mL/min, bottle height: 55 cm) and high (vacuum: 400 mm Hg, aspiration flow: 22 mL/min, bottle height: 90 cm) fluidic parameters during the nucleus was removal. We measured the total surgery time, ultrasound time, and balanced salt solution consumption during phacoemulsification. Best corrected visual acuity (BCVA), PCO score, PCO percentage and severity were measured at 3, 6 and 12 months postoperatively. Endothelial cell density (ECD) was measured preoperatively and 12 months postoperatively.
RESULTS
The study included 20 eyes of 13 patients with low parameters and 20 eyes of 15 patients with high parameters. There was no statistically significant difference in the mean total surgery time, ultrasound time or fluid consumption between the two groups. BCVA and ECD were not significantly different between the two groups during the postoperative follow-up. PCO score, percentage and severity were higher in the low parameter group at 3, 6 and 12 months postoperatively.
CONCLUSIONS
Surgery with low fluid-dynamic parameters is equally effective as with high parameters in terms of surgical time and postoperative BCVA. However, the incidence of PCO was higher in the low fluid-dynamic parameter group up to 12 months. Surgical efforts to reduce remnant lens epithelial cells are needed during low fluidic-dynamic parameter surgery.

Keyword

Cataract; Fluid-dynamic parameters; Phacodynamics; Phacoemulsification; Posterior capsular opacification

MeSH Terms

Cataract
Endothelial Cells
Epithelial Cells
Follow-Up Studies
Humans
Incidence*
Operative Time
Phacoemulsification
Retrospective Studies
Ultrasonography
Visual Acuity

Figure

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  Figure 1. Posterior capsular opacification (PCO) scoring by slit lamp derived reflected light photographs and retroillumination. ‘Grade 0’ means ‘PCO do not intrude the intraocular lens (IOL) edge’. ‘Grade 1’ means ‘PCO intrude less than half of IOL edge area and below the continuous curvilinear capsulorrhexis (CCC) margin’. ‘Grade 2’ means ‘PCO intrude more than half of IOL edge area and below the CCC margin’. ‘Grade 3’ means ‘PCO intrude the CCC margin but do not intrude visual axis’, and ‘Grade 4’ means ‘PCO intrude visual axis’. ‘Visual axis' means ‘3 mm from center of pupil’.

Reference

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