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Why Diamonds are better then Disposable blades?
We conducted a retrospective study of 12,182 consecutive patients who underwent clear corneal phacoemulsifiction, comparing incision technologies.
Group A
In 3,912 patients the main and sideport incisions were created with diamonds.
Group B
In 8,270 patients standard metal keratomes were employed for both incisions.
All patients were seen within 8 hours of surgery.
There were no postoperative wound leaks (0/3,912)at any point in time with a mean first visit postoperative pressure of 19.2 mm Hg in Group A.
There were 9/8,270 (p<0.05) wound leaks with a mean first visit postoperative pressure of 21.6 mm Hg (p<0.05) in Group B.
All 9 wound leaks in Group B were from the sideport. 3/9 wound leaks required suturing. 6/9 wound leaks sealed spontaneously.
The intraocular pressure difference reflected the need to hydrate the wounds more in Group B as they were more difficult to seal and the eyes were left with a higher intraocular pressure at the end of the case. 180/3,912 (4.55%) of patients in Group A had an early IOP spike greater than 28 mm Hg versus 842/8,270 (10.18%) in Group B (p<0.05).
None of the patients in either group experienced an endophthalmitis or vascular occlusion.
We found that the use of diamonds for the incision significantly reduced the rate of wound leaks and the amount of wound hydration resulting in lower early postoperative IOP's and potentially dangerous IOP spikes.
Christoph Kranemann, MD
Clearview Institute
1260 Lawrence Avenue East
Toronto, Ontario M3A 1C4
Canada
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Por que Bisturies de Diamante son
mejores que los desechables?
Amidia realizo un estudio retrospectivo
de 12,182 pacientes que recibieron facoemulsificacion corneal,
comparando los resultados de las inciciones.
Grupo A
En 3,912 pacientes la incision
principal y lateral fueron realizadas con bisturies de diamante.
Grupo B
En 8,270 pacientes se emplearon
keratomos metalicos comunes para ambas incisiones.
Grupo A: Todos los pacientes fueron
revisados dentro de las 8 horas posteriores a la cirugia. No se
encontraron drenajes posoperatorios (0 de 3,912) en ningun punto
durante el periodo, con una presion medida de 19.2mm (Grupo A)
Grupo B: Hubo 9 de 8,270 heridas de
drenaje encontradas con una precion de 21.6mm en el Grupo B
Todos los drenajes encontrados en el
Grupo B fueron en la incision lateral.
3 de las 9 requirieron sutura, 6 de las
9 cerraron espontaneamente.
La diferencia en la presion intraocular
encontrada implico la necesidad de hidratar las heridas mas en Grupo
B debido a que fue mas dificultoso sanar esas heridasde de drenaje, y
los ojos quedaron con una presion remanente mayor al final del
procedimiento.
180 pacientes de 3,912 (4.55%) del
Grupo A tuvieron un pico de presion temprano mayor a 28mm Hg contra
842 de 8,270 (10.18%) en el Grupo B.
Ninguno de los pacientes de ambos
grupos experimentaron endoftalmitis u oclusion vascular.
Encontramos que el uso de Bisturi de
Diamante para la insicion redujo significativamente el porcentaje de
heridas de drenaje y la cantidad de hidratacion, resultando una menor
presion intraocular en el posoperatorio y menores potencialmente
peligrosos picos de presion.
Christoph Kranemann, MD Clearview Institute
1260 Lawrence Avenue East
Toronto, Ontario M3A 1C4
Canada
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