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Phacoemulsification and IOL-implantation without using viscoelastics: combined modeling of thermo fluid dynamics, clinical outcomes, and endothelial cell density

Published inSensors, vol. 21, no. 7, 2399
Publication date2021
Abstract

Phacoemulsification is a widely used surgical method in cataract surgery with a high energy ultrasound source. The viscoelastic is considered to be tissue protective. The aim of this study is to investigate during surgery the impact of using viscoelastic versus no viscoelastic on clinical outcomes, potential complications and effect on endothelial cell density. The study group included 64 patients, who were subjected to phacoemulsification using balanced salt solution (BSS). Control group consisted of 62 patients, who underwent phacoemulsification using Hyaloronic acid 1% Healon 1%. Student's t-test was applied for statistical analysis. The simulations of temperature changes during phacoemulsification were performed by COMSOL Multiphysics software. In the BSS group, a mean endothelial cell loss (ECL) of 4.5% was measured one month postoperatively, while in the Healon group ECL was 5.3%. Data analysis showed no significant difference in ECL between the groups (Student's t-test, p = 0.8). No significant difference was observed in endothelial cell morphology and IOP between the two groups pre- and postoperatively (all p > 0.05). The modeling of thermo fluid dynamics showed that the heating of the cornea is slightly less when Healon was used as irrigation fluid. The phacoemulsification technique can be performed by an experienced surgeon with viscoelastics or continuous anterior chamber (AC) irrigation on the same level of safety regarding endothelial cell damage, providing equally satisfying clinical outcomes.

Keywords
  • Cell Count
  • Endothelial Cells
  • Humans
  • Hydrodynamics
  • Intraocular Pressure
  • Phacoemulsification
  • Prospective Studies
Citation (ISO format)
GOLES, Nikola et al. Phacoemulsification and IOL-implantation without using viscoelastics: combined modeling of thermo fluid dynamics, clinical outcomes, and endothelial cell density. In: Sensors, 2021, vol. 21, n° 7, p. 2399. doi: 10.3390/s21072399
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ISSN of the journal1424-8220
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