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Lens can avoid drying of cornea during surgery

19/07/2017By Matthew Woodley
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A new lens used for observing the fundus with a noncontact wide-angle viewing system during surgery has been able to achieve a clear intraoperative picture during both vitrectomy and scleral buckling procedures.

Drying of the cornea during surgery, which causes poor visibility of the fundus, is one of the most serious issues encountered by surgeons when using a noncontact-type wide-angle viewing system. However, the success of the new lens by a group of surgeons in Kyoto, Japan, means drying may soon no longer be a problem.

According to the study, published by Dove Medical Press, the lens has a thin meniscus made of polymethyl methacrylate and a large outer diameter, which – when combined with its lightweight characteristics – contributes to its overall stabilisation. This means the lens can be put on the cornea without the use of a contact lens fixation ring.

The special lens was used for 82 cases of pars plana vitrectomy, and six cases of scleral buckling with a wide-angle viewing system, between June 2016 and January. In all cases, the fundus images were more clearly visualised when viewed through the contact lens compared with only the viscoelastic material.

This included rhegmatogenous retinal detachment and proliferative vitreoretinopathy cases, in which the retinal breaks at the periphery could be clearly observed through the contact lens during both the fluid and air phases. The improved visibility helped with removing the vitreous traction and proliferative membrane, and also made it possible to safely perform internal drainage and retinopexy.

In addition, the clearer images made it easier to perform the posterior vitreous separation and manipulate the proliferative membrane in diabetic retinopathy. Meanwhile, the use of this lens in scleral buckling proce¬dures assisted with the observation of the fundus during retinopexy with the wide-angle viewing system and made it possible to perform indirect ophthalmoscopy without continuous hydration by an assistant.

No intra- or postoperative complications were encountered in any of the cases.

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A new lens for observing fundus with a noncontact wide-angle viewing system

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