Low molecular-weight heparin in the intraocular irrigating solution in pediatric cataract and intraocular lens surgery.
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Acetates↗
Biomedical subjects
Rupal H Trivedi
Publications and source records attributed to Rupal H Trivedi.
Anterior capsule rupture and subsequent cataract formation in Alport syndrome.
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Cataract↗
Incidence and risk factors for glaucoma after pediatric cataract surgery with and without intraocular lens implantation.
PURPOSE: We sought to report the incidence of glaucoma in the eyes of children who underwent cataract surgery with and without intraocular lens implantation and to report the risk factors for developing glaucoma. METHODS: We undertook a retrospective review of pediatric cataract surgery charts, excluding traumatic cataract, aniridia and Lowe syndrome, steroid-induced cataract, lens subluxation, uveitis, retinoblastoma, radiation-induced cataract, retinopathy of prematurity, secondary IOL implantation, and patients with less than 1 month of postoperative follow-up. RESULTS: After pediatric cataract surgery, 10 (3.8%) of 266 eyes with primary intraocular lens implantation were diagnosed with glaucoma, whereas 8 (17.0%) of 47 aphakic eyes were diagnosed with glaucoma. During the initial analyses, we noted that all of the patients who developed glaucoma underwent cataract surgery when they were 4.5 months or younger. For all patients who underwent surgery during the first 4.5 months of their life, the glaucoma incidence was 24.4% (10/41) in children with pseudophakic eyes and 19.0% (8/42) in age-matched children with aphakic eyes (risk ratio=1.1, CI=0.7-1.9; P=.555). In patients who underwent surgery during the first 4.5 months of their life, the average age of the patients who developed glaucoma was not significantly different than those who did not develop glaucoma in pseudophakic eyes (2.0 months+/-1.4 vs. 1.9 months+/-1.0, P=.700) or aphakic eyes (2.6 months+/-1.5 vs. 1.4 months+/-0.9, P=.070). The corneal diameter of the eyes that developed glaucoma versus eyes that did not was not significantly different in patients with pseudophakic eyes (P=.860) or aphakic eyes (P=.254). Glaucoma was diagnosed in patients at an average of 8.6 months and 117.9 months after cataract surgery in those with pseudophakic eyes and aphakic eyes, respectively. CONCLUSIONS: Patients undergoing cataract surgery at an early age are at high risk for the development of glaucoma with or without an intraocular lens implant.
Age Factors↗
Extensibility and scanning electron microscopy evaluation of 5 pediatric anterior capsulotomy techniques in a porcine model.
PURPOSE: To compare the extensibility and scanning electron microscopy (SEM) of 5 currently used pediatric anterior capsulotomy techniques: vitrectorhexis, manual continuous curvilinear capsulorhexis (CCC), can-opener, radio frequency diathermy, and plasma blade in a porcine model. SETTING: Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS: Extensibility was determined by stretching each capsulotomy until it ruptured and measuring it by calculating the mean stretch-to-rupture circumference of each capsulotomy (20 eyes per technique) as a percentage of its baseline circumference. Edge characteristics were evaluated using SEM. RESULTS: The mean extensibility of each technique tested (vitrectorhexis 161%, CCC 185%, can opener 149%, radio frequency 145%, plasma blade 170%) was significantly different (P<.001, 1-way analysis of variance). The SEM examination found that the vitrectorhexis had a scalloped edge with the whole edge rolled over, presenting a smooth surface toward the inside of the capsulotomy; the manual CCC produced the smoothest edge, with no irregularities noted; the can-opener edge was irregular, showing each puncture of the needle had created a small arc, with occasional regions of the edge rolled over in a "hit-and-miss" fashion; the radio-frequency diathermy capsulotomy edge was ragged, rough, and irregular; and the plasma blade capsulotomy edge was rougher than the manual CCC, but there were fewer irregularities than the radio-frequency diathermy edge had. CONCLUSIONS: The manual CCC technique produced the most extensible porcine capsulotomy, followed by the plasma blade, vitrectorhexis, can-opener, and radio-frequency techniques, in a porcine model. The manual CCC technique also produced the smoothest anterior capsulotomy edge according SEM evaluation.
Animals↗
Iris-cyst-simulating luxated lens.
A 2-month-old child was referred to our clinic for evaluation and management of a luxated lens. Under general anesthesia, an irregularly shaped iris was observed with the presence of a large iris cyst in the anterior chamber. Sector iridectomy with excision of the cyst was performed. Histopathologic examination confirmed the diagnosis of a stromal cyst of the iris. At the 3-year follow-up, there was no evidence of recurrence of the iris cyst or of a secondary cataract. This case report provides evidence that although a primary cyst of the iris stroma is uncommon, it should be considered in the differential diagnosis for an apparent lens luxation.
Cysts↗
Interocular axial length difference in eyes with pediatric cataracts.
PURPOSE: We sought to report interocular axial length difference (IALD) between the operated eye and fellow eye at the time of pediatric cataract surgery. METHODS: A retrospective analysis of 171 cataractous (operated) eyes (mean patient age at surgery, 56.9 months; range, 0.2-230.0) was undertaken. Descriptive statistics, analysis of covariance, and regression analysis were used in statistical analysis. RESULTS: The mean IALD was 0.05 +/- 1.15 mm. If absolute values were used, mean IALD was 0.76 +/- 0.86. Nearly half of the subjects (48.0%) showed an IALD of >/=0.5 mm. Forty-one patients (24.0%) had operated (cataractous) eyes that were >/=0.5 mm shorter than the fellow eye, and 41 patients (24.0%) had operated eyes that were >/=0.5 mm longer than the fellow eye. The mean IALD in unilateral and bilateral cases was 0.10 +/- 1.33 and -0.03 +/- 0.76, respectively (P = 0.4). If absolute values were used, it was 0.98 +/- 0.90 and 0.40 +/- 0.65 in unilateral and bilateral cases, respectively (P < 0.001). IALD was more predictable in unilateral than in bilateral cases (P < 0.001). In unilateral cases, age at surgery (P = 0.04) and AL of the operated eye (P < 0.001) correlated with IALD. IALD did not correlate with gender, ethnicity, or type of cataract in either unilateral or bilateral cases. CONCLUSIONS: An IALD of >/=0.5 mm occurred in 48.0% of patients with pediatric cataracts and occurred more often with unilateral cataractous patients than with bilateral cases. In patients with unilateral cataract, age at surgery and AL of the operated eye could help predict the IALD.
Cataract↗
Secondary intraocular lens implantation for pediatric aphakia.
PURPOSE: We sought to report the outcome of secondary intraocular lens (IOL) implantation in children. METHODS: This was a retrospective case review. RESULTS: A total of 77 eyes were identified. An average age at secondary implantation was 7.8 +/- 5.0 years, whereas the average age at primary cataract surgery was 1.5 +/- 2.6 years. Average follow-up was 2.7 +/- 1.9 years. Thirty eyes received a hydrophobic acrylic IOL implantation whereas 47 eyes received a PMMA IOL. The sites of fixation for implanted IOLs were as follows: anterior-chamber (n = 6), sulcus (n = 42), in-the-bag (n = 14), optic-capture (n = 6), piggyback (n = 4), and sutured (n = 5). Complications included clinically significant decentration, 4 (5.2%); visual axis opacification, 4 (5.2%); dislocation of the IOL, 2 (2.6%); and pupillary capture requiring repositioning of IOL, 1 (1.3%). Clinically significant decentration requiring surgical intervention was noted only in eyes with sulcus-fixated foldable IOLs (28.6%; 4/14). None of the 29 eyes with sulcus-fixated PMMA IOL implantation developed decentration. All the decentrations were in an inferior direction and occurred in eyes of male patients (P = 0.03). Eyes with an axial length of >23 mm were 4 times more likely to develop decentration if implanted with a sulcus-fixated foldable IOL when compared with eyes measuring <23 mm (P = 0.03). Postoperative geometric mean visual acuity was significantly better than preoperative visual acuity (P < 0.001). CONCLUSION: Secondary IOL implantation can be safely achieved in pediatric eyes. In-the-bag fixation of foldable IOLs is associated with a low rate of complications. Foldable lenses appear to have a higher rate of decentration than PMMA lenses when placed in the sulcus in eyes of myopic male patients.
Adolescent↗
New techniques and technologies for pediatric cataract surgery.
PURPOSE OF REVIEW: This paper surveys the literature from April 2004 to April 2005 and addresses trends in pediatric cataract surgery techniques. RECENT FINDINGS: The evolution of pediatric cataract surgery continues, with many adult cataract surgical techniques being applied to children with minor technical adjustments. More and more, surgeons are implanting intraocular lenses in younger children. One of the most widely reported technologic advances in 2004-2005 was the use of hydrophobic acrylic intraocular lenses in children. Predicting axial growth, and refractive change that accompanies it, is one of the major remaining challenges for the long-term care of children who have had cataract surgery. SUMMARY: Automation and intraocular lenses have helped to provide better anatomic and functional outcome for cataract surgery in children. Two major challenges in the coming years will be to find a way to obviate invasive procedures like posterior capsulotomy and vitrectomy and to study the growth of eyes in a well designed prospective study that will help to design new intraocular lens power calculation formulas specifically suited for children's eyes.
Cataract Extraction↗
Eye growth after pediatric cataract surgery.
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Aphakia, Postcataract↗
Opacification of the visual axis after cataract surgery and single acrylic intraocular lens implantation in the first year of life.
PURPOSE: To report the incidence and risk factors for secondary surgical intervention to treat visual axis opacification (VAO) after cataract surgery and acrylic intraocular lens (IOL) implantation during the first year of life. METHODS: A retrospective review of 29 eyes of 20 patients receiving a hydrophobic acrylic (AcrySof; Alcon, Fort Worth, TX) IOL implantation was conducted. All eyes underwent primary posterior capsulectomy and anterior vitrectomy. Statistical analysis was performed using SPSS for Windows (SPSS, Chicago, IL). RESULTS: Average age at surgery was 4.8 +/- 3.7 months, and average follow-up was 33.4 +/- 16.1 months. Eleven of 29 (37.9%) eyes developed VAO requiring secondary surgical intervention at a median of 4.8 months (95% confidence interval 3.4 to 6.2). Average age at surgery for eyes that subsequently opacified was 3.8 +/- 3.0 months compared with 5.4 +/- 4.0 months for those whose visual axis remained clear (P = 0.26). The relative risk of subsequent VAO surgery was 2.7 for primary surgery performed at or before the first 6 months of life. Opacification was significantly related to eyes with associated ocular anomalies (eg, anterior segment dysgenesis, iris hypoplasia, or persistent fetal vasculature) with a relative risk of 8.6 (P < 0.001). Proliferation of cortex was the most common form of VAO, followed by mixed-type with predominantly fibrous, fibrous alone, or Elschnig pearls. When secondary surgery was required, it occurred primarily during the first 6 months (ie, 9 of 11 patients) after the initial cataract surgery. CONCLUSIONS: When cataract and IOL surgery was undertaken within the first year of life, a secondary surgical procedure was required in 37.9% of eyes to maintain a clear visual axis. Most secondary surgery for VAO occurred within the first 6 months after surgery. Postoperative opacification was most common in eyes with associated ocular anomalies.
Acrylates↗
Visual axis opacification after AcrySof intraocular lens implantation in children.
PURPOSE: To evaluate visual axis opacification after AcrySof intraocular lens (IOL) (Alcon) implantation in pediatric eyes. SETTING: Iladevi Cataract and IOL Research Centre, Ahmedabad, India. METHODS: This prospective study evaluated 103 consecutive eyes of 72 children with congenital cataract. Two groups were formed based on age at surgery: Group 1, younger than 2 years, and Group 2, older than 2 years. All eyes in Group 1 (n = 37) had primary posterior continuous curvilinear capsulorhexis (PCCC) with anterior vitrectomy. In Group 2 (n = 66), management of the posterior capsule was assigned randomly to no PCCC (Group 2A, n = 37) or PCCC (Group 2B, n = 29). The PCCC group was further randomized into 2 subgroups: no vitrectomy (Group 2BN, n = 14) or vitrectomy (Group 2BV, n = 15). The primary outcome measures were visual axis opacification and the resulting need for a secondary procedure. Statistical analysis was performed using SPSS for Windows (version 11.0.1). RESULTS: The mean age of the patients was 5.2 years +/- 5.0 (SD) (range 0.2 to 16.0 years) and the mean follow-up, 2.3 +/- 0.9 years (range 1.0 to 4.0 years). Overall, 41 eyes (39.8%) developed visual axis opacification and 14 (13.6%) required secondary intervention. In Group 1, 4 eyes (10.8%) developed visual axis opacification and 3 (8.1%) had a secondary pars plana vitrectomy. In Group 2A, 31 eyes (83.8%) developed posterior capsule opacification (PCO) and 10 eyes (27.7%) had secondary intervention. Children 8 years or younger at the time of surgery developed significantly greater PCO than older children (P =.01). Five eyes (37.5%) in Group 2BN had opacification of the anterior vitreous face, 1 of which required a secondary procedure. One eye (6.7%) in Group 2BV had visual axis opacification that did not require a secondary procedure. CONCLUSIONS: AcrySof IOL implantation with appropriate management of the posterior capsule maintained a clear visual axis in 60.2% of eyes. Of the 39.8% of eyes with visual axis opacification, 13.6% had visually significant opacification and required a secondary procedure.
Acrylic Resins↗
Capsular bag opacification after experimental implantation of a new accommodating intraocular lens in rabbit eyes.
PURPOSE: To evaluate the development of capsular bag opacification in rabbit eyes after implantation of an intraocular lens (IOL) designed to minimize contact between the anterior capsule and the IOL and ensure expansion of the capsular bag. SETTING: David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. METHODS: Ten New Zealand white rabbits had a study IOL (new accommodating silicone IOL [Synchrony, Visiogen, Inc.]) implanted in 1 eye and a control IOL (1-piece plate silicone IOL with large fixation holes) implanted in the other eye. Intraocular lens position, anterior capsule opacification (ACO), and posterior capsule opacification (PCO) were qualitatively assessed using slitlamp retroillumination photographs of the dilated eyes. Anterior capsule opacification and PCO were graded on a 0 to 4 scale after the eyes were enucleated (Miyake-Apple posterior and anterior views after excision of the cornea and iris). The eyes were also evaluated histopathologically. RESULTS: The rate of ACO and PCO was significantly higher in the control group. Fibrosis and ACO were almost absent in the study group; the control group exhibited extensive capsulorhexis contraction, including capsulorhexis occlusion. Postoperative IOL dislocation into the anterior chamber and pupillary block syndrome were observed in some eyes in the study group. CONCLUSIONS: The special design features associated with the study IOL appeared to help prevent PCO. Complications in the study group were probably caused by the increased posterior vitreous pressure in rabbit eyes compared to human eyes and the relatively large size of the study IOL relative to the anterior segment of rabbit eyes.
Animals↗
Correlation between different measurements within the eye relative to phakic intraocular lens implantation.
PURPOSE: To obtain measurements of the white-to-white distance and the anterior chamber and ciliary sulcus diameters in phakic human eyes obtained post-mortem to find a correlation between these measurements. SETTING: David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. METHODS: Twenty-two phakic human eyes obtained from eye banks within 24 hours of death were evaluated. The following measurements were performed: white-to-white distance, anterior chamber diameter with a plastic sizer after a small limbal incision, and anterior chamber and ciliary sulcus diameters after fixation and sagittal section of the eyes. The first 10 eyes were studied at the 6 o'clock to 12 o'clock meridian and the last 12 eyes, at the 3 o'clock to 9 o'clock meridian. RESULTS: A positive correlation was found between the white-to-white measurements and the anterior chamber diameter in the 10 eyes studied at the 6 o'clock to 12 o'clock meridian but not in the 12 eyes studied at the 3 o'clock to 9 o'clock meridian. The latter is the meridian frequently used by surgeons to perform white-to-white measurements and thus choose the overall size of the phakic intraocular lens to be implanted. No correlation was found between the white-to-white measurements and the ciliary sulcus diameter in the 2 meridians. CONCLUSION: Experimental studies using cadaver eyes are helpful in evaluating sizing techniques for phakic IOL implantation as well as in better understanding the anatomical relationships between ocular structures.
Aged↗
Anterior vitreous face behavior with AcrySof in pediatric cataract surgery.
PURPOSE: To describe anterior vitreous face behavior when AcrySof (Alcon, Fort Worth, TX) intraocular lenses come in contact with the anterior vitreous face after posterior continuous curvilinear capsulorhexis without anterior vitrectomy in pediatric patients undergoing cataract surgery. METHODS: This study comprised 14 eyes of 12 children whose mean age was 9.6 years (range, 2.3 to 16.0). All eyes underwent primary posterior continuous curvilinear capsulorhexis without anterior vitrectomy and had AcrySof IOLs implanted in the bag. Changes on the anterior vitreous face were documented, and visual acuity was recorded. Statistical analysis was performed using Student group t and Mann Whitney tests. RESULTS: Mean length of follow-up was 21.1 +/- 7.4 months (range, 15.0 to 36 months). Nine eyes (64.3%) had a clear visual axis, whereas 5 eyes (35.7%) developed anterior vitreous face changes. Of those with anterior vitreous face changes, 60% (3 of 5) eyes showed a fine meshwork-like reticular response termed "anterior vitreous reticular response" (AVR); 20% (1 of 5) eyes showed a scaffold response; and 20% (1 of 5) eyes showed a mixed response at the last follow-up examination. The difference in visual acuity before and after the development of the AVR response was not significant (P =.712). The mean age of patients with eyes having a clear visual axis was 12.1 +/- 2.3 years (median = 11.0; range, 9.1 to 16.0), and the mean age of patients with eyes having anterior vitreous face changes was 5.1 +/- 3.4 years (median = 3.6; range, 2.3 to 11.6) (P =.0098). CONCLUSION: The results suggest that when the AcrySof intraocular lenses come in contact with the anterior vitreous face, they produce the AVR response during the early postoperative period in younger eyes. This does not seem to have any significant impact on visual acuity.
Acrylic Resins↗
Randomized, clinical trial of multiquadrant hydrodissection in pediatric cataract surgery.
PURPOSE: Evaluate efficacy of multiquadrant cortical-cleaving hydrodissection in pediatric cataract surgery. DESIGN: Randomized multicenter clinical trial. METHODS: Surgery performed at Iladevi Cataract & IOL Research Center (57 eyes, 42 patients) and Postgraduate Institute of Medical Education and Research (23 eyes, 17 patients). Study population comprised 59 consecutive patients (80 eyes) 12 years old and younger undergoing cataract aspiration. The intervention procedure involving envelope randomization was used to assign patients to multiquadrant cortical-cleaving hydrodissection (HY) (40 eyes), or no hydrodissection (HN) (40 eyes). The main outcome measures were as follows: (1) lens-substance removal time and volume of fluid used and (2) ease of lens substance removal. Presence or absence of residual fibers on the posterior capsule was recorded. RESULTS: The mean +/- standard deviation lens substance removal time was significantly less in the HY group (156.1 +/- 86.8 seconds) than in HN group (210.7 +/- 73.8 seconds; P =.003). Fluid used for lens substance removal was significantly less in the HY (91.0 +/- 47.5 ml) than in the HN group (156.9 +/- 87.2 ml; P <.001). In the HY group, lens substance removal was ranked as easy in 36 eyes (90.0%), average in 2 eyes (5.0%), and difficult in 2 eyes (5.0%). In the HN group, removal was easy in 19 eyes (47.5%), average in 12 eyes (30.0%), difficult in 5 eyes (12.5%), and very difficult in 4 (10.0%) eyes (P =.0005). Residual cortical fibers on the posterior capsule were noted in 12.5% of the HY group and 22.5% of HN group, but the difference was not statistically significant (P =.2). CONCLUSIONS: Multiquadrant cortical-cleaving hydrodissection decreases lens substance removal time, lessens fluid volume used for lens substance removal, and facilitates lens substance removal in pediatric cataract surgery.
Cataract↗
Viscoanesthesia. Part I: toxicity to corneal endothelial cells in a rabbit model.
PURPOSE: To evaluate the toxicity of a solution combining sodium hyaluronate 1.5% with lidocaine (0.5%, 1.0%, or 1.65%) to the rabbit corneal endothelium. SETTING: Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS: Each rabbit cornea was excised, and the endothelium was exposed to 1 of the following solutions for 20 minutes: viscoanesthetic solution (0.5%, 1.0%, or 1.65% lidocaine in sodium hyaluronate 1.5%; 5 corneas each), sodium hyaluronate 1.5% (n = 5), balanced salt solution (BSS(R)) (n = 5), mitomycin-C 0.02% (n = 2), dextran 15% (n = 2), or distilled water (n = 2). The endothelium was then stained with trypan blue and alizarin red. Two corneas were stained immediately after excision. Cell morphology and damage to the corneal endothelium were analyzed by microscopic examination. RESULTS: The endothelium in the corneas of the viscoanesthetic groups was comparable to that in the sodium hyaluronate 1.5% and the BSS groups and to the corneas not exposed to any solution. In some areas of the 1.0% and the 1.65% viscoanesthesia groups, the corneal endothelial cells presented irregular intercellular borders. Staining with trypan blue, which indicates cellular damage, was observed in some linear areas corresponding to corneal folds in all groups. The folds were probably caused during manipulation for corneal excision and staining. The corneal endothelium was destroyed in the mitomycin group. In the dextran and distilled-water groups, morphological alterations probably resulting from osmotic changes were observed. CONCLUSIONS: The 3 concentrations of viscoanesthetic solutions appeared to be safe to rabbit corneal endothelium.
Acetates↗
Viscoanesthesia. Part II: toxicity to intraocular structures after phacoemulsification in a rabbit model.
PURPOSE: To investigate the toxicity of a solution that combines sodium hyaluronate 1.5% with lidocaine (0.5%, 1.0%, or 1.65%) to intraocular structures. SETTING: Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS: Phacoemulsification was performed in both eyes of 29 rabbits. They were divided into 3 groups; in each group (n = 7), 1 viscoanesthetic solution was used before capsulorhexis. After irrigation/aspiration, 0.2 mL of the solution was purposely left in the capsular bag. In 1 rabbit in each group, the solution was injected into the vitreous cavity through a posterior capsulorhexis. In 8 rabbits used as controls, balanced salt solution (BSS(R)) (n = 4) or sodium hyaluronate 1.5% (n = 4) was injected into the vitreous cavity. Enucleations were performed 15, 30, and 60 days postoperatively. Histological sections were cut and stained with hematoxylin-eosin, periodic acid-Schiff, and Masson trichrome stains. RESULTS: Light microscopic evaluation of the eyes enucleated after 15, 30, and 60 days in the study and control groups showed similar findings in intraocular structures such as the ciliary body and retina. No evidence of an inflammatory reaction, cell necrosis, or cell degeneration was observed in the histological sections. CONCLUSIONS: The use of viscoanesthesia during phacoemulsification appeared to be safe, with no histologic abnormalities observed with the 3 lidocaine concentrations. The efficacy of the anesthetic effects of these solutions will be addressed in clinical trials.
Anesthetics, Local↗
Viscoanesthesia. Part III: removal time of OVD/viscoanesthetic solutions from the capsular bag of postmortem human eyes.
PURPOSE: To investigate and evaluate the removal time of various ophthalmic viscosurgical device (OVD)/viscoanesthetic solutions containing sodium hyaluronate 1.5% with different concentrations of lidocaine (0.5%, 1.0%, and 1.65%). SETTING: Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS: Six postmortem human eyes were prepared per the Miyake-Apple posterior video technique. Capsulorhexis, hydrodissection/delineation, and nuclear emulsification were performed, followed by thorough cleaning of the capsular bag using an irrigation/aspiration (I/A) tip. The time and ease of removal of 4 solutions from the capsular bag were evaluated. The solutions were Ophthalin Plus (sodium hyaluronate, 15 mg/mL) and sodium hyaluronate 15 mg/mL mixed with lidocaine 0.5%, lidocaine 1.0%, and lidocaine 1.65%. The solutions were dyed with fluorescein to enhance visualization. After the capsular bag was filled with 1 of the solutions, a posterior chamber intraocular lens was implanted. The solution was then aspirated using an automated I/A device set at 250 mm Hg of aspiration. The time required to remove most and then all the material was recorded. RESULTS: The mean time required for removal of most of the Ophthalin Plus, viscoanesthesia 0.5%, viscoanesthesia 1%, and viscoanesthesia 1.65% solutions was 8.7 seconds +/- 2.1 (SD), 7.7 +/- 1.1 seconds, 9.7 +/- 0.6 seconds, and 6.3 +/- 1.5 seconds, respectively (P =.1). The mean time to remove all the solutions was 21.3 +/- 3.2 seconds, 19.7 +/- 2.5 seconds, 18.3 +/- 3.2 seconds, and 15.7 +/- 2.1 seconds, respectively (P =.166). No subjective difference in viscosity or consistency was found among the solutions. CONCLUSIONS: The addition of lidocaine to the OVD solution did not significantly alter the viscosity or consistency of the solution or change its removal time from the capsular bag.
Anesthetics, Local↗