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Modelling of the Soft Shell Technique Using Computational Fluid Dynamics.

Ippei Watanabe1, Hirokazu Mukuno2

  • 1Medical Affairs, Seikagaku Corporation, Chiyoda-ku, Tokyo, Japan.

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Summary

Ophthalmic viscosurgical devices (OVDs) were simulated during the soft shell technique. Dispersive-OVD formed a protective layer, while cohesive-OVD efficiently filled the eye, demonstrating distinct behaviors crucial for surgical prediction.

Keywords:
cataract surgerychondroitin sulfatehyaluronic acidophthalmic viscosurgical devices

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Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Fluid Dynamics

Background:

  • The soft shell technique is vital in ophthalmic surgery for protecting ocular tissues.
  • Understanding the fluid dynamics of ophthalmic viscosurgical devices (OVDs) is crucial for optimizing surgical outcomes.

Purpose of the Study:

  • To elucidate the behavior of ophthalmic viscosurgical devices (OVDs) during the soft shell technique through fluid dynamics simulation.
  • To analyze the interplay between dispersive and cohesive OVDs in a simulated ocular environment.

Main Methods:

  • Simulated fluid dynamics of a dispersive OVD (3% hyaluronic acid [HA] and 4% chondroitin sulfate) and a cohesive OVD (1% HA) using Fluent2023R2 and ICEM CFD.
  • Evaluated mass fraction, static pressure, velocity, shear rate, and apparent viscosity during simulated intraocular injection of 0.1 mL of each OVD.

Main Results:

  • Dispersive-OVD injection resulted in minimal intraocular pressure rise, forming a protective layer on the corneal endothelium.
  • Cohesive-OVD injection increased velocity towards the incision and overflowed, with higher shear rates and lower apparent viscosity near the cannula tip compared to dispersive-OVD.
  • Dispersive-OVD at the endothelial surface exhibited low shear rates (<10⁻¹–10 s⁻¹) and apparent viscosity (<30–100 Pa·s) during cohesive-OVD injection.

Conclusions:

  • Fluid dynamics simulations effectively demonstrated the mechanisms of the soft shell technique with OVDs of differing properties.
  • The study provides key parameters for understanding and predicting OVD behavior in ophthalmic surgery.