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Corneal Endothelial Damage by Air Bubbles During Phacoemulsification

Authors
 Eung K. Kim  ;  Stephen M. Cristol  ;  Dayle H. Geroski, PhD  ;  Bernard E. McCarey  ;  Henry F. Edelhauser 
Citation
 ARCHIVES OF OPHTHALMOLOGY, Vol.115(1) : 81-88, 1997 
Journal Title
ARCHIVES OF OPHTHALMOLOGY
ISSN
 0003-9950 
Issue Date
1997
MeSH
Air ; Animals ; Child ; Endothelium, Corneal/injuries* ; Endothelium, Corneal/ultrastructure ; Eye Injuries/etiology* ; Eye Injuries/pathology ; Humans ; Microscopy, Electron, Scanning ; Middle Aged ; Phacoemulsification/adverse effects* ; Rabbits ; Surface Tension ; Therapeutic Irrigation
Abstract
To characterize the mechanism by which air bubbles damage the corneal endothelium during phacoemulsification.

MATERIALS AND METHODS:
A series of experiments was conducted to expose the corneal endothelium of New Zealand white rabbit and human eyes that were obtained from an eye bank to air under different conditions. Phacoemulsification at different power settings and irrigation with and without the introduction of air into the anterior chamber were performed. Corneal endothelial perfusion experiments were conducted with air bubbles that were introduced into the perfusion chamber for 2 seconds to 1 hour. Air was also injected into the anterior chambers of anesthetized rabbits for 2 minutes to 3 hours. Corneas were stained with nitrobenzo-xadiazole-phallacidin and examined with fluorescence microscopy. Selected corneas were also examined with scanning and transmission electron microscopy.

RESULTS:
Intracameral air bubbles during phacoemulsification, irrigation, and perfusion studies resulted in a severe injury to the corneal endothelium in as little as 20 seconds. Intracameral air bubbles in a living rabbit resulted in a slower injury that was morphologically different from the more rapid injury.

CONCLUSIONS:
Air bubbles in intraocular fluids with a high surface tension can cause a ring-shaped pattern of damage to the corneal endothelium. The mechanism that caused this pattern of damage appears to be a surface tension phenomenon.
Full Text
https://jamanetwork.com/journals/jamaophthalmology/fullarticle/641952
DOI
10.1001/archopht.1997.01100150083014
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eung Kweon(김응권) ORCID logo https://orcid.org/0000-0002-1453-8042
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/177262
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