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OPHTHALMIC IMAGE
Year : 2021  |  Volume : 1  |  Issue : 3  |  Page : 457

A novel sign for the endpoint of viscoaspiration - “Fluid gush disappearance”


Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India

Date of Web Publication02-Jul-2021

Correspondence Address:
Dr. Amber A Bhayana
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3749_20

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How to cite this article:
Khokhar SK, Bhayana AA, Deora A, Prasad P. A novel sign for the endpoint of viscoaspiration - “Fluid gush disappearance”. Indian J Ophthalmol Case Rep 2021;1:457

How to cite this URL:
Khokhar SK, Bhayana AA, Deora A, Prasad P. A novel sign for the endpoint of viscoaspiration - “Fluid gush disappearance”. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Jul 26];1:457. Available from: https://www.ijoreports.in/text.asp?2021/1/3/457/320087



During viscoaspiration[1] through side ports after intraocular lens injection in small incision cataract surgery, in the beginning aspiration port is plugged by the viscoelastic. The rate of viscoelastic aspiration is thus less than the rate of fluid infusion. This causes a rise in the intraocular pressure which starts pushing anterior chamber contents (viscoelastic and saline) out of the large incision (here scleral incision was 5.5 mm) seen in the form of fluid gush and wound gape [Figure 1]a. Eventually as the viscoelastic amount in anterior chamber reduces, the rate of aspiration eventually rises, leading to decrease in the intraocular pressure leading to lesser amount of fluid gush and lesser wound gape [Figure 1]b, finally leading to a stable intraocular pressure with no gush of fluid and a well apposed surgical wound [Figure 1]c when viscoelastic is completely aspirated out. We would thus like to propose disappearance of fluid gush from a large incision as a sign of endpoint of viscoaspiration from the anterior chamber. This is a sensitive test and is also seen through unhydarted 2.2 corneal incisions in case bimanual sideport irrigation and aspiration.
Figure 1: Viscoaspiration after injection of lens in small incision cataract surgery. (a) shows viscoelastic in anterior chamber (black arrow) with surgical wound gape with fluid gush (blue arrow); (b) viscoelastic has reduced in amount (black arrow) and so has the fluid gush and wound gape (blue arrow); (c) there is no viscoelastic in anterior chamber and the surgical wound is well apposed and dry with fluid gush

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  References Top

1.
Mitani A, Suzuki T, Tasaka Y, Uda T, Hiramatsu Y, Kawasaki S, et al. Evaluation of a new method of irrigation and aspiration for removal of ophthalmic viscoelastic device during cataract surgery in a porcine model. BMC Ophthalmol 2014;14:129.  Back to cited text no. 1
    


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