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Researchers recommend removing cotton balls from cataract surgery packs
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Removing cotton balls from the surgical packs used for cataract surgery can significantly reduce the frequency of fibers introduced into the anterior chamber, according to a prospective study by researchers in Japan.
In order to evaluate the frequency and source of fibrous materials in the anterior chamber during and after cataract surgery, Hiroyuki Shimada, MD, PhD, and colleagues examined 837 eyes of 623 patients who underwent surgery at Setagaya-Shimoda Hospital in Tokyo.
In group one, the investigators examined the postoperative frequency of fibers found in the anterior chambers of 422 eyes of 292 patients. These patients were followed for 1 year to detect any postoperative inflammation of the anterior chamber. In group two, the investigators compared fibrous materials removed intraoperatively from 78 eyes of 57 patients to the fibrous materials used in surgical packs during surgery. In group three, the surgeons removed highly dust-generating material, including cotton balls and gauze, from surgical packs before performing surgery on 337 eyes of 274 patients and determining the frequency of fibers in the anterior chamber during surgery.
Postoperatively, the investigators found fibers in the anterior chambers of seven eyes (1.7%) in group one. However, over 1-year follow-up, none of these eyes had inflammation, they noted.
Intraoperatively, the investigators observed fibers in the anterior chambers of five eyes (6.4%) in group two that were identical to the cotton fibers in cotton balls and gauze.
Of all the fibrous material used during surgery, cotton balls generated the most dust, they said.
Removing cotton balls from the surgical packs significantly reduced the frequency of fibers to five eyes (1.5%) in group three (P = .0239), according to the study.
"We recommend replacing dust-generating fibrous materials such as cotton balls and gauze to achieve nearly fiber-free conditions," the authors said in the August issue of Journal of Cataract & Refractive Surgery.