The New Cannula Aspiration Technology to Treat Complete Lens Dislocation: A Prospective Randomized Clinical Trial

This pilot study aimed to evaluate the outcomes of a novel large-bore cannula aspiration technology developed in our laboratory in comparison to phacofragmentation for addressing complete lens dislocation.

Thirty-seven eyes with complete lens dislocation were randomly assigned to two groups. In both groups, standard 3-port pars plana vitrectomy (PPV) was performed to remove the vitreous. The dislocated lens was removed by phacofragmentation or the large-bore cannula aspiration technology, based on the random grouping. The "cannula" aspiration instrument was made of the trocar of a 20-G vein detain needle. After the suction line was twisted off, the "cannula" was connected to the proximal end of the suction line. Nineteen eyes were treated with this novel large-bore cannula aspiration technology and the remaining 18 eyes were operated with phacofragmentation to extract the dislocated lenses. Patients were followed up for ≥ 6 months. Several relevant indicators were compared between the two groups, including intraocular pressure (IOP), the change in IOP from preoperative to postoperative measurements, and the incidence of postoperative complications.

There were no significant differences in demographic and baseline characteristics between the two groups. Mean duration of surgery was comparable between the two groups. Three eyes in the phacofragmentation group had scleral burns, whereas no scleral burns were observed in the aspiration group. In terms of IOP, the phacofragmentation group exhibited lower IOP compared to the aspiration group on both the first and second days postsurgery (P < .01). Additionally, during the same postoperative period, the difference in IOP between preoperative and postoperative was significantly smaller in the aspiration group compared to the phacofragmentation group (P < .01). However, IOP levels were comparable between the two groups 1 week after surgery.

This pilot study demonstrated that the new large-bore cannula aspiration technology can be effectively used for lens extraction. The large-bore cannula aspiration technology avoids the use of ultrasonic energy, thereby eliminating the direct risk of thermal scleral injury and potential retinal damage from ultrasound shockwaves. Thus, this new large-bore cannula aspiration technology can be further explored for complete lens dislocation surgery.