PURPOSE To assess the efficacy and safety of a new technique, back-flow hydrodissection. SETTING Hirota Eye Clinic, Yamaguchi, and Department of Ophthalmology, University of Tsukuba, Ibaraki, Japan. DESIGN Prospective case series and experimental study. METHODS For back-flow hydrodissection, the irrigation line was connected to the aspiration port of an irrigation/aspiration handpiece using a female-female connector with the irrigation port open. The balanced salt solution was irrigated from the aspiration tip opening with constant pressure, hydrodissection was performed, and the excess fluid was evacuated via the sleeve lumen. In a clinical study, 200 eyes were randomly assigned to conventional hydrodissection with an irrigation cannula or back-flow hydrodissection. In experimental studies, intraocular pressure (IOP) fluctuation and fluid dynamics in the anterior and posterior chamber were evaluated in porcine eyes. RESULTS The lens became freely mobile in the capsular bag in 99 (99%) of 100 eyes and in 96 (96%) of 100 eyes in the back-flow hydrodissection group and conventional hydrodissection group, respectively (P = .369). There were no between-group differences in any other surgery-related parameters, including surgical time and the complication rate. In porcine eyes, conventional hydrodissection induced a significantly larger increase in IOP than back-flow hydrodissection (P < .0001). Conventional hydrodissection immediately washed out fluorescein-stained ophthalmic viscosurgical device (OVD) from the anterior chamber, while there was little leakage of OVD from the eye with back-flow hydrodissection. The endoscopic view showed that conventional hydrodissection induced rapid and severe bulging of the posterior capsule; however, bulging was gentle and mild with back-flow hydrodissection. CONCLUSION Back-flow hydrodissection was safe and effective in disengaging the lens from the capsule, ensuring a freely mobile lens.

中文翻译：

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新型回流水解剖技术的临床和实验评估。

目的评估回流水解剖的新技术的有效性和安全性。设置山口广田眼科医院和日本茨城县筑波大学眼科。设计前瞻性案例系列和实验研究。方法对于逆流水解剖，将冲洗管线使用开放式冲洗器上的母-雌连接器连接到冲洗/手持式手机的抽吸口。从抽吸尖端的开口以恒定压力冲洗平衡的盐溶液，进行水力解剖，多余的液体通过套管腔排空。在一项临床研究中，将200只眼睛随机分配到带有冲洗套管或逆流水解剖的常规水解剖中。在实验研究中 在猪眼中评估眼前房和后房的眼内压（IOP）波动和流体动力学。结果在逆流水解剖组和常规水解剖组中，晶状体分别在100眼的99眼（99％）和100眼的96眼（96％）中在囊袋中自由移动（P = .369）。在其他与手术相关的参数（包括手术时间和并发症发生率）方面，组间无差异。在猪眼中，常规水解剖比倒流水解剖引起的IOP显着增加（P <.0001）。常规水切割术立即从前房冲洗掉了荧光素染色的眼科内窥镜手术器械（OVD），而回流水切割术几乎没有从眼睛漏出OVD。内窥镜检查结果显示，传统的水分离术会导致后囊快速而严重的膨出。但是，鼓胀温和且温和，伴有逆流性淋巴结清扫术。结论回流水切术在将晶状体从囊中分离出来是安全有效的，可确保晶状体自由移动。