Transient temperature distribution on the corneal endothelium during ophthalmic phacoemulsification: A numerical simulation using the nodeless variable element

Abstract

Background: During cataract operation (phacoemulsification), a phaco needle-tip is inserted into the anterior chamber of eye. Then, heat is generated by the oscillation of the phaco needle, which may injury the corneal endothelial cells. There are no data available for temperature responses at the corneal endothelium to heat from the phaco needle during phacoemulsification. Objective: Investigate temperature distribution on the corneal endothelium during ophthalmic phacoemulsification using numerical simulation, and compare the transient temperature response to heat between balanced salt solution (BSS) and ophthalmic viscoelastic device (OVD), Viscoat®. Methods: Heat flux from a phaco needle was measured with thermal properties of BSS and AVS in an experimental setting. Then, nodeless variable finite element method was applied to predict temperature changes in the eye by the phaco needle inserted into the anterior chamber. The transient temperature distribution on the corneal endothelium was calculated at 10, 20, and 30 seconds after heat generation by the needle. Results: The heat generation of phaco needle without sleeve cover was 1.6 kW/m2. The numerical simulation showed that the maximum temperature occurs on the wound location at all times after heat generation by the phaco needle. Especially, at time 30 seconds, it was 49.2 and 41.7°C in BSS and OVD, respectively. The temperature elevation by the phaco needle was lower in OVD than BSS. Conclusion: Phacoemulsification is a heat-generating procedure performed between the anterior chamber structures of eye. During this procedure, OVD may protect the corneal endothelium against heat better than BSS.