Air bubble stops bleeding, avoids pressure spikes during phaco in glaucoma patients
MILAN — Injecting an air bubble into the anterior chamber may help stop hyphema while also avoiding pressure spikes during cataract surgery in patients with glaucoma, according to a surgeon here.
“Studies have shown that intraoperative IOP rises above 30 mm Hg in 10% of uncomplicated phaco cases. In glaucoma patients, the high pressure tends to persist into the following week,” Steven Dewey, MD, said at the annual joint meeting of Ocular Surgery News and the Italian Society of Ophthalmology.
Dewey discovered a safe, easy solution to this problem by chance when trying to stop the bleeding generated while he was irrigating the chamber to wash out the viscoelastic.
“Bleeding occurred, and I used air to stop it by compression. I placed a filtered air bubble inside the chamber and left it in place for 60 seconds. It’s an easy and effective maneuver, which can be repeated if the bleeding doesn’t stop. In the end, you aspirate the air out,” he said.
Dewey found that patients who underwent this air bubble procedure had very low IOP after surgery.
“The air does not allow viscoelastic to hide inside the eye, so this is a great maneuver to wash it out more effectively. This also avoids pressure spikes during surgery,” Dewey said.
Disclosure: Dewey is a consultant to AMO.