Silicone-tipped I/A handle confe

Results from a large retrospective analysis confirms that use of a silicone-tipped instrument for irrigation and aspiration (I/A) decreases the risk of posterior capsule rupture.

The study was reported by Atul Varma, MD, and based on data from the ophthalmology department of The MidYorkshire Hospitals NHS Trust, United Kingdom, where the silicone-tipped I/A instrument was introduced for use of all cataract surgeries beginning in September, 2011. The analyses included 4,754 consecutive eyes operated on with a metal tipped I/A instrument during the 2 years prior to the instrument change and compared their outcomes with those of 4,681 eyes that underwent surgery in the 2 years after the switch was made.
Posterior capsule rupture, including cases with or without vitreous loss and those with zonular dialysis, occurred in 96 eyes (2.02%) operated on with the metal-tipped I/A and in 87 eyes (1.86%) after the silicone-tipped I/A was introduced. However, in both groups, most of these complications occurred during phacoemulsification. Considering only events encountered during I/A, there were 16 cases in the group operated on with the metal-tipped I/A and only 1 case using the silicone-tipped instrument (0.34% vs. 0.02%).

“Our study definitely shows a dramatic reduction in complication rates during I/A after switching to the silicone tip, and our finding is consistent with the results from various other studies,” said Dr. Varma.

“We believe the silicone-tipped device should be the I/A handle of choice for all cataract surgeries, and especially those done by trainees considering data from the UK Cataract National Dataset Electronic Patient Record audit show a posterior capsule rupture rate of up to 16% in their hands.”