Raghudeep Eye Hospital, Ahmedabad, Gujarat, India.
Indian J Ophthalmol. 2019 Oct;67(10):1634-1637. doi: 10.4103/ijo.IJO_465_19.
To evaluate the eff ect of different aspiration flow rates (AFR) and bottle heights (BH) on vitreous face (AVF) during phacoemulsifi cation.
Experimental study in 20 porcine eyes. Transzonular viscodissection was performed between the posterior capsule(PC) and AVF to dissect out the Berger's space. Triamcinolone acetonide was injected into this space to aid visualization with ultrasound B-Scan(USG). Realtime USG was performed during phacoemulsifi cation. Eyes were divided randomly into-Group I: Low parameters(AFR = 20 cc/min, BH = 90 cm, vacuum = 400 mmHg),and Group II: High parameters (AFR = 40 cc/min, BH = 110 cm, vacuum=650 mm Hg).
15 eyes were analysed (8 in Group I; 7 in Group II). In all eyes, forward and backward movement of the PC was seen when going from foot position 0 to 1, or on occlusion break. Amplitude of these movements was much greater in Group II compared to Group I. There was no PC rupture in either group. In 2 of the 7 eyes in Group II, USG showed a sudden, spontaneous dispersion appearance of sono-opaque echoes in the vitreous cavity alongwith disappearance of the well-defi ned, crescentic stained space despite an intact PC. This suggests rupture of the AVF, leading to dispersion of the triamcinolone into the entire vitreous cavity. No AVF rupture was seen in Group I.
We report a rarely described entity of AVF rupture with intact PC. The use of high AFR and BH may have clinically invisible detrimental consequences to the anterior vitreous face.
评估不同的抽吸流速（AFR）和瓶高（BH）对白内障乳化过程中玻璃体前表面（AVF）的影响。
在 20 只猪眼进行实验研究。在后囊（PC）和 AVF 之间进行经巩膜粘性分离，以分离出 Berger 空间。向该空间内注射曲安奈德以辅助超声 B 扫描（USG）可视化。在白内障乳化过程中进行实时 USG。将眼睛随机分为-组 I：低参数（AFR = 20 cc/min，BH = 90 cm，真空= 400 mmHg）和组 II：高参数（AFR = 40 cc/min，BH = 110 cm，真空= 650 mmHg）。
分析了 15 只眼睛（组 I 中 8 只；组 II 中 7 只）。在所有眼睛中，当从足位 0 移动到 1 或在闭塞中断时，均可见 PC 向前和向后移动。与组 I 相比，组 II 中这些运动的幅度要大得多。两组均未发生 PC 破裂。在组 II 的 7 只眼中的 2 只眼中，USG 显示尽管 PC 完整，但玻璃体腔内的声-不透明回声突然自发分散，同时新月形染色空间消失，提示 AVF 破裂，导致曲安奈德分散到整个玻璃体腔中。在组 I 中未观察到 AVF 破裂。
我们报告了一种罕见的 AVF 破裂且 PC 完整的情况。使用高 AFR 和 BH 可能会对前玻璃体表面产生临床上不可见的不利影响。
