Purifying air over the operating field with a new mobile laminar airflow device to reduce the possibility of airborne contamination.

PURPOSE: To investigate the effectiveness of a mobile laminar airflow (LAF) device designed to reduce both airborne particles and lint fibers within the sterile field during cataract surgery. SETTING: Cincinnati Eye Institute, Cincinnati, Ohio. DESIGN: Prospective case series. METHODS: The number of airborne particles sized 0.5 µm, 1.0 µm, and 1.5 µm were measured at different locations and times during 116 routine phacoemulsification procedures with and without the use of a mobile LAF device. In a companion study, the presence of lint fibers in 99 eyes undergoing cataract surgery with a mobile LAF device was compared with 50 eyes in the control group. Lint fibers were differentiated as either falling onto the ocular surface or being carried into the sterile field by an instrument. RESULTS: A statistically significant reduction (P < .0005) occurred in all 3 particle sizes measurements when the LAF device was used: 79.0% (93.6 ± 16.1 vs 445.3 ± 30.9), 81.7% (11.30 ± 1.98 vs 61.85 ± 5.34), and 90.8% (0.241 ± 0.056 vs 2.624 ± 0.362) in the 0.5 µm, 1.0 µm and 5.0 µm particles, respectively. Lint fibers were identified in 18% (9/50) of eyes in the control group and 16.16% (16/99) of eyes in the LAF group. Although the number of lint fibers carried into the sterile field was similar in each group, the incidence of lint fibers falling onto the sterile field was reduced from 6% (3/50) to 0% (0/99) when the LAF was used (P = .014). CONCLUSIONS: The mobile LAF device was highly effective in reducing the number of particulate matter and lint fibers within the sterile surgical field when used during cataract surgery.

Long-term follow-up of a custom-made prosthetic iris device in patients with congenital aniridia.

PURPOSE: To investigate the effectiveness and safety of a custom-made iris prosthetic device used to reduce photic symptoms in patients with congenital aniridia. SETTING: Cincinnati Eye Institute, Cincinnati, Ohio, USA. DESIGN: Retrospective single-surgeon case series. METHODS: The charts of all eyes of patients diagnosed with congenital aniridia syndrome who underwent implantation of the custom-made iris prosthesis at the setting institution between 2008 and 2018 were reviewed. Eyes with more than 6 months of follow-up were included in evaluation. Charts were carefully reviewed for comorbid conditions, interventions, and outcomes. RESULTS: Ninety-six eyes of 50 patients were included in the study. Subjective reduction in photophobia and glare was reported in 95.7% and 95.2% of cases, respectively. The incidence of aniridia fibrosis syndrome (AFS) in this study (3.1%; 95% confidence interval, 0.6%-8.9%) was similar to previous studies in the literature. CONCLUSIONS: The custom-made iris prosthesis was an effective and safe option to reduce photic symptoms in patients with congenital aniridia. The custom, flexible iris implant does not appear to alter the risk for AFS. These highly complex eyes with significant comorbid pathologies demand an individualized approach and careful long-term follow-up.

Brazilian technique for prevention of the Argentinean flag sign in white cataract.

We describe a technique that prevents the Argentinean flag sign in white cataract. The technique is based on the intumescent cataract having 2 rather than 1 pressurized compartments within the crystalline lens, the anterior and the posterior. The pressure that pushes the nucleus upward, which is the movement responsible for a radial tear of the anterior capsule, does not come from the vitreous but from the posterior intralenticular pressurized compartment. We also present a nomenclature system to help the phacoemulsification surgeon distinguish the 3 types of senile white cataracts and prevent intrasurgical complications peculiar to each one.