High eye pressure may cause various problems during cataract surgery. New technologies allow doctors to stabilize this pressure without reducing the blood flow into the optic nerve. An obvious advantage linked to these technologies is the ability to perform cataract surgery without further increasing pressure in the eye.
We spoke to prof. Paolo Vinciguerra, head of the Ophthalmology Center at Humanitas.
Why choose low eye pressure cataract surgery?
During the operation, we also need to replace the volume of liquid we remove. In the past, given that we did not have very sophisticated instruments to measure inlet and outlet pressure, cataract operations tended to use systems that pushed a lot of pressure into the eye.
In normal conditions, eye pressure fluctuates between 10 and 15 millimeters of mercury. During these old school operations with old tools, the pressure may even be raised up to 80-90 millimeters of mercury. Almost 8 or 9 times the pressure to which the eye is accustomed.
This means the eye structure is stretched and can sometimes cause pain despite the anesthesia. Moreover, as the eye pressure rises, the blood flow that enters from the optic nerve is reduced more and more. The eye is therefore likely to remain with no blood supply during the entire intervention.
This is particularly dangerous for patients suffering from other conditions like glaucoma where a few minutes without blood flow may accelerate nerve damage. Keep in mind, that a nerve structure that doesn’t have blood for a few minutes may suffer an inflammation. Resulting in a much longer recovery time.
Instead, here at Humanitas,we use precise systems to carry out the suction and filling of the liquid by setting the pressure to 20 millimeters of mercury, this is the maximum pressure to which the eye is used to, thus avoiding influencing the circulatory dynamics of the eye.
What are the benefits?
Another advantage linked to these systems is the ability to maintain a low temperature within the eye.
Amongst the new tools at our disposal there is a new tip. This tip has the ability to drain the eye without raising the temperature within the eye. In the past, the tip in question became warm and some areas even touched 50 degrees.
A 45 degree temperature is no longer just hot, it becomes painful. At Humanitas we have set the objective of not exceeding 40 degrees. Furthermore, holding this maximum temperature only in one point, the farthest from the eye.
This point is not in contact with the ocular structures but is immersed in water and is then immediately cooled by the incoming and outgoing flow. This factor helps make recovery quicker and less painful, ensuring a better result in the long run.