J.ophthalmol.(Ukraine).2019;1:33-38.

http://doi.org/10.31288/oftalmolzh201913338

Received: 17 December  2018; Published: 28 February 2019 

Intraoperative changes in intraocular temperature during vitrectomy procedures with irrigating solutions differing in temperature

L.I. Anatychuk,1,2  Member of the NAS of Ukraine, Dr Sc (Phys and Math), Prof.; N.V. Pasyechnikova,3 Assoc Member of the NAMS of Ukraine, Dr Sc (Med), Prof.; V.A. Naumenko,3 Dr Sc (Med), Prof.; R.E. Nazaretian,3 ophthalmologist; M.M. Umanets,3 Dr Sc (Med); R.R. Kobylianskyi,1,2  Cand Sc (Phys and Math); O.S. Zadorozhnyy,3  Cand Sc (Med)

1 Institute of Thermoelectricity of the National Academy of Science and Ministry of Education and Science, Ukraine;  Chernivtsi (Ukraine);

2 Yuriy Fedkovych Chernivtsi National University;  Chernivtsi (Ukraine);

3 Filatov Institute of Eye Diseases and Tissue Therapy, NAMS of Ukraine;   Odessa (Ukraine);

E-mail:  laserfilatova@gmail.com

Background: Intraoperative intraocular media and irrigation fluid temperature monitoring is not performed during vitreoretinal surgery in current clinical practice.

Purpose: To investigate intraoperative changes in intraocular temperature at the major steps of vitreoretinal surgery with irrigating solutions differing in temperature.

Materials and Methods: Thirty-nine patients (39 eyes) were under observation before, during and after vitrectomy. Group 1 (20 patients; 20 eyes) and Group 2 (19 patients; 19 eyes) differed with respect to the baseline temperature (24.2 ± 0.52 °С, or 10.3 ± 1.1 °С, respectively) of the irrigating fluid. Room air temperature, irrigating fluid temperature, patient’s body temperature, blood pressure, heart rate and blood oxygen saturation, vitreous temperature, and duration of every step of the vitreoretinal procedure were recorded in all cases.

Results: Vitrectomy with 24°C or 10°C irrigating solutions resulted in a substantial decrease in temperature in vitreous compartments to the level of moderate or deep hypothermia, respectively. In addition, immediately after vitrectomy, the lowest temperatures were found in the anterior vitreous, and were 30.1 ± 0.45 °С for the 24°C group and 24.37±0.52 °С for the 10°C group. Moreover, after additional surgical manipulations, in the presence of discontinued irrigation, the temperatures in the vitreous compartments were found to gradually increase. 

Conclusion: Vitreoretinal surgery is performed under conditions of induced uncontrolled local hypothermia, which requires intraoperative monitoring of intraocular temperature and irrigating solution temperature. During a vitroretinal procedure lasting up to 30 minutes, the intraocular contents may be safely cooled to the level of deep hypothermia.

Keywords: vitroretinal surgery, intraocular temperature, human eye

References

  1. Zadorozhnyy OS, Nazaretian RE, Myrnenko VV, et al. Structure of the chorioretinal complex in the rabbit eye after vitrectomy. Report 1. Vitreous cavity irrigation with different temperature solutions for 30 minutes. J Ophthalmol (Ukraine). 2018;3:73-84.
  2. Iguchi Y, Asami T, Ueno S, et al. Changes in vitreous temperature during intravitreal surgery. Invest Ophthalmol Vis Sci. 2014 Apr 11;55(4):2344-9. doi: 10.1167/iovs.13-13065.
  3. Nazaretian RE, Zadorozhnyy OS, Umanets NN, et al. Intraocular temperature changes during vitrectomy procedure.  J Ophthalmol (Ukraine). 2018;6:30-4.
  4. Rinkoff J, Machemer R, Hida T, et al. Temperature-dependent light damage to the retina. Am J Ophthalmol. 1986 Oct 15;102(4):452-62.
  5. Tamai K, Toumoto E, Majima A. Local hypothermia protects the retina from ischaemic injury in vitrectomy. Br J Ophthalmol. 1997 Sep;81(9):789-94.
  6. Jabbour NM, Schepens CL, Buzney SM. Local ocular hypothermia in experimental intraocular surgery. Ophthalmology. 1988 Dec;95(12):1687-90.
  7. Romano MR, Romano V, Mauro A, et al. The effect of temperature changes in vitreoretinal surgery. Transl Vis Sci Technol. 2016;5:4.
  8. Zadorozhnyy OS, Nazaretian RE, Myrnenko VV, et al. Structure of the chorioretinal complex in the rabbit eye after vitrectomy. Report 2. Vitreous cavity irrigation with different temperature solutions for 60 minutes. J Ophthalmol (Ukraine). 2018;4:49-53.
  9. Anatychuk LI, Pasyechnikova NV, Zadorozhnyy OS, et al. [A thermoelectric device for measuring intraocular temperature]. Thermoelektrika. 2015;3:31-40. Ukrainian.
  10. Anatychuk LI, Pasyechnikova NV, Zadorozhnyy OS, et al. A thermoelectric device for and approaches to temperature measurement in various ocular compartments. J Ophthalmol (Ukraine). 2015;6:50-3. 
  11. Alzaga AG, Cerdan M, Varon J. Therapeutic hypothermia. Resuscitation. 2006 Sep;70(3):369-80.
  12. Polderman KH, Herold I. Therapeutic hypothermia and controlled normothermia in the ICU: Practical considerations, side effects, and cooling methods. Crit Care Med. 2009;37:1101-20.
  13. Saad H, Aldawy M. Temperature management in cardiac surgery. Glob Cardiol Sci Pract. 2013 Nov 1;2013(1):44-62. doi: 10.5339/gcsp.2013.7.
  14. The Hypothermia after Cardiac Arrest Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002 Feb 21;346(8):549-56.
  15. Yenari MA, Han HS. Neuroprotective mechanisms of hypothermia in brain ischaemia. Nat Rev Neurosci. 2012 Feb 22;13(4):267-78. doi: 10.1038/nrn3174.
  16. Marcleod MR, Petersson J, Norrving В, et al. Hypothermia for Stroke: call to action 2010. Int J Stroke. 2010;5(6):489-92.
  17. Nunnally ME,  Jaeschke R, Bellingan GJ, et al. Targeted temperature management in critical care: A report and recommendations from five professional societies. Crit Care Med. 2011;39:1113–25.
  18. Lomivorotov VN. [Hypothermic protection of the brain in cardiac surgery]. Patologiia krovoobrashcheniia i kardiokhirurgiia. 2010;3:7-10. Russian.