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Safety of air tamponade versus corneal hydration for sealing clear corneal incisions in cataract surgery

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Abstract

Purpose

To compare safety of wound hydration to anterior chamber air tamponade for securing watertight closure of clear corneal incisions, during uneventful cataract surgery.

Methods

Prospective, comparative case-control series. Patients undergoing phacoemulsification were assigned to receive either anterior chamber air bubble (Group A) or intrastromal wound hydration with balanced salt solution (Group B) at the end of the procedure. Two high-volume surgeons operated equal number of cases in each group employing identical surgical technique, except for corneal side incision management. Patients were assessed pre- and postoperatively at day 1, day 4, day 9, and day 30 after surgery.

Results

One hundred eyes of 100 patients were enrolled, of which 2 were lost to follow-up. The two groups were comparable in terms of preoperative risk factor assessment, baseline central corneal thickness (CCT), preoperative endothelial cell density, as well as cumulative dissipated energy and duration of phacoemulsification (p > 0.05). Mean CCT and best-corrected visual acuity were better in Group B on the first postoperative day, but did not differ between the two groups at all other timepoints. Surgically induced astigmatism was comparable in the two groups (p > 0.05). Endothelial cell density loss at 1 month postoperatively was greater in Group A (34.06%) compared to Group B (16.45%).

Conclusions

Wound sealing with intrastromal hydration proved to be safer than air tamponade in terms of preserving endothelial cell density and function.

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References

  1. Matossian C, Makari S, Potvin R (2015) Cataract surgery and methods of wound closure: a review. Clin Ophthalmol 9:921–928

    PubMed  PubMed Central  Google Scholar 

  2. Vasavada V, Vasavada AR, Vasavada VA, Srivastava S, Gajjar DU, Mehta S (2013) Incision integrity and postoperative outcomes after microcoaxial phacoemulsification performed using 2 incision-dependent systems. J Cataract Refract Surg 39(4):563–571

    Article  Google Scholar 

  3. Mehdizadeh M, Rahat F, Khalili MR, Ahmadi F (2010) Effect of anterior chamber air bubble on prevention of experimental Staphylococcus epidermidis endophthalmitis. Graefes Arch Clin Exp Ophthalmol 248(2):277–281

    Article  Google Scholar 

  4. Ti SE, Chee SP, Tan DT, Yang YN, Shuang SL (2013) Descemet membrane detachment after phacoemulsification surgery: risk factors and success of air bubble tamponade. Cornea 32(4):454–459

    Article  Google Scholar 

  5. Tsinopoulos IT, Lamprogiannis LP, Tsaousis KT, Mataftsi A, Symeonidis C, Chalvatzis NT, Dimitrakos SA (2013) Surgical outcomes in phacoemulsification after application of a risk stratification system. Clin Ophthalmol 7:895–899

    Article  Google Scholar 

  6. Holladay JT (2004) Visual acuity measurements. J Cataract Refract Surg 30(2):287–290

    Article  Google Scholar 

  7. Kopsachilis N, Tsaousis KT, Tsinopoulos IT, Welge-Luessen U (2013) Air toxicity for primary human-cultured corneal endothelial cells: an in vitro model. Cornea 32(4):e31–e35

    Article  Google Scholar 

  8. Landry H, Aminian A, Hoffart L, Nada O, Bensaoula T, Proulx S, Carrier P, Germain L, Brunette I (2011) Corneal endothelial toxicity of air and SF6. Invest Ophthalmol Vis Sci 52(5):2279–2286

    Article  CAS  Google Scholar 

  9. Marques RE, Guerra PS, Sousa DC, Ferreira NP, Gonçalves AI, Quintas AM, Rodrigues W (2018) Sulfur hexafluoride 20% versus air 100% for anterior chamber tamponade in DMEK: a meta-analysis. Cornea 37(6):691–697

    Article  Google Scholar 

  10. Ple-Plakon PA, Shtein RM (2014) Trends in corneal transplantation: indications and techniques. Curr Opin Ophthalmol 25(4):300–305

    Article  Google Scholar 

  11. Güell JL, El Husseiny MA, Manero F, Gris O, Elies D (2014) Historical review and update of surgical treatment for corneal endothelial diseases. Ophthalmol Ther 3(1–2):1–15

    Article  Google Scholar 

  12. Gonzalez A, Price FW Jr, Price MO, Feng MT (2016) Prevention and management of pupil block after Descemet membrane endothelial keratoplasty. Cornea 35(11):1391–1395

    Article  Google Scholar 

  13. Alsmman AH, Ezzeldawla M, Mounir A, Elhawary AM, Mohammed OA, Farouk M, Sherif AM (2018) Effect of reformation of the anterior chamber by air or by a balanced salt solution (BSS) on corneal endothelium after phacoemulsification: a comparative study. J Ophthalmol 2018:6390706

    PubMed  PubMed Central  Google Scholar 

  14. Calladine D, Tanner V (2009) Optical coherence tomography of the effects of stromal hydration on clear corneal incision architecture. J Cataract Refract Surg 35(8):1367–1371

    Article  Google Scholar 

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Correspondence to Asimina Mataftsi.

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The authors declare that they have no conflict of interest.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the Papageorgiou Hospital and Aristotle University of Thessaloniki and with the 1964 Helsinki Declaration and its later amendments. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Mataftsi, A., Dermenoudi, M., Matsou, A. et al. Safety of air tamponade versus corneal hydration for sealing clear corneal incisions in cataract surgery. Graefes Arch Clin Exp Ophthalmol 258, 815–820 (2020). https://doi.org/10.1007/s00417-020-04602-1

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  • DOI: https://doi.org/10.1007/s00417-020-04602-1

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