Use of the anterior chamber maintainer in anterior segment surgery

Over a 12 month period, we used the anterior chamber maintainer (ACM) in cataract surgery in 258 patients; ages ranged from 15 to 95 years (mean 73 years). Surgery was performed using general or local anesthesia. The procedures were standard extracapsular cataract extraction (ECCE), mini-nuc ECCE, vectis extraction of the endonucleus, manual phacofragmentation, phacoemulsification, phacotrabeculectomy, repositioning the IOL, and anterior segment revision. We recorded our subjective assessment of the degree of anterior chamber (AC) maintenance and control of the position of the posterior capsule during surgery. We also kept clinical notes of the practical aspects of the procedures. The AC was well maintained in all patients throughout the surgery; posterior position of the posterior capsule was maintained during irrigation/aspiration. Five patients required the use of a viscoelastic agent at some stage. Our subjective assessment is that use of the ACM increased surgical control of the anterior chamber depth and position of the posterior capsule during surgery. Provided that it is used correctly, the ACM may offer increased safety during anterior segment surgery and require less use of viscoelastic agents.