Real-time intraocular pressure measurement during phacoemulsification in dogs ex vivo

This study was performed to evaluate changes in intraocular pressure (IOP) during standard coaxial phacoemulsification using 4 different bottle heights (BHs) and 2 different incision sizes. Coaxial phacoemulsification was performed with a venturi-based machine in 8 enucleated canine eyes through 3.0 and 3.2 mm clear corneal incisions (CCIs). A pressure transducer inserted in the peripheral cornea monitored the IOP in real-time. The surgery was subdivided into 4 stages: sculpt-segment removal, irrigation/aspiration, capsular polishing and viscoelastic removal. The mean IOP and the difference between the maximum and minimum IOPs were calculated at each stage and compared. The ultrasound time and volume of irrigation fluid used were recorded. The mean IOP increased with an elevation in the BH. The mean IOP in the irrigation/aspiration stage was significantly higher than that in the sculpt-segment removal stage at the same BH. The difference between the maximum and minimum IOP at each stage was greater in the 3.2 mm than the 3.0 mm CCIs, although the mean IOP was lower with the 3.2 mm than the 3.0 mm CCIs. The ultrasound time and irrigation fluid volume were greater with the 3.2 mm than the 3.0 mm CCIs. Therefore, fluidic parameters during each stage could be reassessed and adjusted to reduce complications arising from an elevated IOP. Phacoemulsification with 3.0 mm CCIs at a lower BH might lead to less stress on the eye from IOP fluctuations, ultrasound energy and irrigation fluid.