ESCRS - PO0495 - Hydroinsertion With A Twist

Hydroinsertion With A Twist

Published 2023 - 41st Congress of the ESCRS

Reference: PO0495 | Type: Free paper | DOI: 10.82333/yex6-j153

Authors: Christopher Liu* 1 , George Liu 2 , Kessara Pathanapitoon 3 , Napaporn Tananuvat 4

1Tongdean Eye Clinic,Hove,United Kingdom, 2School of Medicine,Anglia Ruskin University,Chelmsford,United Kingdom, 3Head of Glaucoma and Uveitis,Chiang Mai University Hospital,Chiang Mai ,Thailand, 4Cornea & Refractive Surgery Unit,Chiang Mai University Hospital,Chiang Mai ,Thailand

Purpose

Description of full glaucoma protocol and hydro-insertion of intraocular lens (IOL) to reduce pressure spike and wipe out in glaucomatous eyes undergoing cataract surgery.

Setting

Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust

Methods

Evidence based protocol and description of IOL hydro-insertion technique.

Results

The full glaucoma protocol consists of using a clear temporal corneal incision (to reduce disturbance to any pre-existing glaucoma filtration bleb, and to preserve superior conjunctiva in case drainage surgery is required at a later date); topical and intracameral anaesthesia and avoidance of high volume sub-Tenons or peribulbar local anaesthesia which can cause huge intraorbital and thus intraocular pressure rise; deploying dispersive instead of cohesive ophthalmic viscoelastic device (OVD) where possible; full removal of OVD including behind the IOL; topical anti-hypertensives such as Iopidine or Timolol providing no contraindication; and oral Acetazolamide for up to two days.

Conclusions

In addition to a full glaucoma protocol to protect vulnerable glaucomatous eyes against pressure spikes and rises, the IOL hydro-insertion adds to safety as no OVD is left within the anterior chamber at the end of cataract surgery. Hydro-insertion has been used by the senior author and his team for five years in over 1000 cases uneventfully. Under irrigation using the bimanual irrigation probe, the IOL is inserted into the bag in one manoeuvre. Surgical videos of the technique will be shown.