Evaluation Of Early Changes Of The Anterior Vitreous Interface After Cataract Surgery, Using Low-Pressure Settings Determined By Oct.

Hydrodynamics and pressure fluctuations during cataract surgery can alter the normal attachment of the vitreous lens interface.

Clinica de ojos Tandil, Buenos Aires. Argentina.

This is an exploratory work with no previously published articles (pilot study). A sample size of 80 patients (40 per group) undergoing cataract/clear lens phacoemulsification surgery was considered sufficient to test the hypothesis. Fisher's test will be used to compare proportions. To compare numerical variables, the Student's t-test or the Mann-Whitney test will be used. The level of significance will be considered with a p <0.05. In each clinic there will be a single surgeon, both will use the same equipment, Centurion Vision System with active fluidics and Active Sentry.Using pressure settings at 30 mmhg and 80 mmhg.

80 eyes of 80 patients. Age 50 to 70 years (mean 66.43 SD 4.2) Axial length 22 to 25 mm (mean 23.41mm SD 0.73). Cataract surgery and IOL implantation (Centurion Vision System with Active fluidics and Active Sentry) were performed. Two groups (40 each group) randomly divided: Group 1 infusion pressure 30 mmHg, flow rate 45 cc/min and vacuum 450 mmHg and Group 2 infusion pressure 80 mmHg, flow rate 45 cc/min and vacuum 450 mmHg. In the postoperative period, the presence of positive Berger's space was evidenced in 7.5% (n=3) of the eyes of group 1 and in 42.5% (n=17) of the eyes of group 2. A statistically significant relationship was established using Fisher's exact test (P value = 0.0003)

Phacoemulsification can damage the anterior hyaloid membrane. Positive Berger's space after phacoemulsification is a biomarker of this damage and can occur in eyes without risk factors. Incidence is directly related to the infusion pressure and the type of fluidic used. Surgeons should avoid high infusion pressures and IOP fluctuation during phaco.