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Electron microscopy of silicone irrigation/aspiration tips involved in posterior capsule rupture

John C Hart1, Michael Tanner1, David M Rooney1

  • 1From the Department of Ophthalmology (Hart, Rooney), William Beaumont Hospital, Oakland University/William Beaumont School of Medicine (Hart, Rooney), and the Department of Clinical Engineering (Tanner), William Beaumont Hospital, Royal Oak, Michigan, USA.

Journal of Cataract and Refractive Surgery
|October 13, 2018
PubMed

Insights

Two cases of posterior capsule rupture were linked to Alcon reusable silicone irrigation/aspiration (I/A) tips. Microscopic analysis revealed tip defects, leading to capsule tears during cataract surgery.

Area of Science:

  • Ophthalmology
  • Surgical Instrumentation
  • Cataract Surgery

Background:

  • Posterior capsule rupture (PCR) is a potential complication during cataract surgery.
  • The integrity of surgical instruments is crucial for patient safety.

Observation:

  • Two cases of PCR were associated with reusable Alcon silicone irrigation/aspiration (I/A) tips.
  • Microscopic examination showed burring on inner metallic shafts and tears in silicone sleeves of the I/A tips.

Findings:

  • PCR occurred when the posterior capsule was aspirated through the I/A tip's aspiration port or a tear in its silicone sleeve.
  • Sharp metallic burrs on the inner metal tube of the I/A tips were identified as a cause of posterior capsule rupture.

Implications:

  • This highlights the importance of meticulous inspection and maintenance of reusable surgical instruments.
  • Potential design improvements or material changes for I/A tips may reduce the risk of PCR.
  • Surgeons should be aware of potential instrument-related risks during cataract surgery.

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