Lee Jung Pil, Kim Jinsoo, Park Inwon, Ra Ho, Kwon Soonil
Department of Ophthalmology, Incheon Medical Center, Incheon 22532, Republic of Korea.
Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea.
Int J Ophthalmol. 2018 Nov 18;11(11):1809-1813. doi: 10.18240/ijo.2018.11.12. eCollection 2018.
To assess the optimal conditions for preventing condensation of objective lens during vitrectomy with noncontact wide-angle viewing systems (WAVSs).
We explored the effectiveness of the coating with ophthalmic viscoelastic device (OVDs) on the corneal surface and the soaking the objective lens in warm-saline for preventing condensation of objective lens. First, to find the optimal soaking time to keep the objective lens warm, we measured the temperature of objective lens every minute after soaking in warm saline. Second, to find optimal distance between cornea and objective lens, which provide as wide a view as possible and less condensation at the same time, we measured the condensation time with different distances. With the obtained optimal soaking time and distance, we explored the effect of coating cornea with OVDs and soaking objective lens in warm saline on condensation time.
One and 5min of soaking in warm saline was most effective for keeping the lens warm enough (45.1°C±2.1°C for 1min and 46.4°C ±1.0°C for 5min, =0.109). The mean condensation times for the control group at 1, 3, and 5 mm from corneal surface to objective lens were 1±0.4, 4±1.4, 190±26.1s, respectively, thus 5 mm was most optimal distance for vitrectomy with WAVSs. For the OVD coating group, the mean condensation times were 1.5±0.3, 13±1.4, and 200±23.9s at 1, 3, and 5 mm distance and borderline significant compared with control group (=0.068, 0.051, and 0.063, respectively). With the 1-minute warm saline soaking group, the mean condensation time were extended to 188±34.4, 416±65.7, and 600±121.3s at 1, 3, and 5 mm distance and statistically significant compared with control (=0.043, 0.041 and 0.043, respectively).
OVD coating on corneal surface shows no difference on condensation time with control group. However, soaking the objective lens in warm saline revealed statistically significant extension of condensation time compared to control group. Therefore, keeping the objective lens warm with soaking in warm saline is a simple but effective to prevent condensation of objective lens during vitrectomy. The thermodynamics between objective lens and cornea during vitrectomy warrants further investigation.
评估在使用非接触式广角观察系统(WAVS)进行玻璃体切除术期间防止物镜冷凝的最佳条件。
我们探讨了在角膜表面涂抹眼科粘弹性装置(OVD)以及将物镜浸泡在温盐水中以防止物镜冷凝的效果。首先,为了找到保持物镜温暖的最佳浸泡时间,我们在将物镜浸泡在温盐水中后每分钟测量其温度。其次,为了找到角膜与物镜之间的最佳距离,该距离要能提供尽可能宽的视野且同时减少冷凝,我们测量了不同距离下的冷凝时间。利用获得的最佳浸泡时间和距离,我们探讨了用OVD涂抹角膜以及将物镜浸泡在温盐水中对冷凝时间的影响。
在温盐水中浸泡1分钟和5分钟对于使透镜保持足够温暖最为有效(浸泡1分钟时为45.1°C±2.1°C,浸泡5分钟时为46.4°C±1.0°C,P = 0.109)。从角膜表面到物镜距离为1、3和5毫米时,对照组的平均冷凝时间分别为1±0.4、4±1.4、190±26.1秒,因此5毫米是使用WAVS进行玻璃体切除术的最佳距离。对于OVD涂抹组,在距离为1、3和5毫米时,平均冷凝时间分别为1.5±0.3、13±1.4和200±23.9秒,与对照组相比接近显著水平(分别为P = 0.068、0.051和0.063)。对于1分钟温盐水浸泡组,在距离为1、3和5毫米时,平均冷凝时间延长至188±34.4、416±65.7和600±121.3秒,与对照组相比具有统计学显著性(分别为P = 0.043、0.041和0.043)。
角膜表面涂抹OVD在冷凝时间方面与对照组无差异。然而,将物镜浸泡在温盐水中与对照组相比,冷凝时间有统计学显著性延长。因此,在玻璃体切除术期间通过将物镜浸泡在温盐水中来保持其温暖是一种简单而有效的防止物镜冷凝的方法。玻璃体切除术期间物镜与角膜之间的热力学关系值得进一步研究。