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Impact of swirling lens fragments during phacoemulsification

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Session Details

Session Title: Cataract Surgery Equipment/Instrumentation/Surgical Devices

Session Date/Time: Monday 09/10/2017 | 16:30-18:00

Paper Time: 16:30

Venue: Room 4.4

First Author: : K.Stjepanek AUSTRIA

Co Author(s): :    N. Hirnschall   S. Amir-Asgari   O. Findl              

Abstract Details


Classification and quantification of swirling lens fragments during phacoemulsification using a continuous intra-operative optical coherence tomography (ReScan700; Carl Zeiss Meditec AG, Germany)


Vienna Institute for Ocular Surgery (VIROS), a Karl-Landsteiner institute, Hanusch Hospital, Vienna, Austria 


Cataract patients scheduled for surgery were included in this prospective study. During surgery, continuous intra-operative OCT (ReScan700, Carl Zeiss Meditec AG, Germany) recordings were performed to score swirling lens fragments that came into contact with the corneal endothelium. Screenshots of the intraoperative OCT-videos were created whenever a fragment hit the endothelium. The fragments position (center/periphery), size (large/medium/small), contact area (diffuse/pinpoint) and duration of the impact (long/short) were measured and analysed. In a sub-set of patients specular microscopy was performed to assess endothelial cell count before and 1 month after surgery.


442 lens fragments were detected in 59 eyes. 62% hit the center of the cornea, 38% hit the periphery. 53% had a pinpoint-sized contact area whereas 47% had a larger contact area. The measured endothelial cell loss was higher whenever there were more small fragments with a pinpoint contact area that hit the center of the cornea. More data on how the fragments induced the endothelial cell loss will be presented at the meeting.


Swirling lens fragments are a risk factor for the endothelium, leading to endothelial cell loss when hitting the cornea. With central impacts of small fragments leading to the most damage, novel techniques to protect the endothelium might be promising, but more data is needed to prove a possible benefit. 

Financial Disclosure:


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