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Article: Second instrument tip breaks during phacoemulsification

TitleSecond instrument tip breaks during phacoemulsification
Authors
KeywordsEquipment failure
Eye foreign bodies
Intraoperative complications
Phacoemulsification
Siderosis
Issue Date2008
PublisherCanadian Ophthalmological Society. The Journal's web site is located at http://www.eyesite.ca/english/program-and-services/cjo/index.htm
Citation
Canadian Journal Of Ophthalmology, 2008, v. 43 n. 6, p. 702-706 How to Cite?
AbstractBackground: Second instrument tip breaks during phacoemulsification are complications that are anecdotally recalled, yet little information exists on why and how often they occur, whether they are consistently tracked, and how they are managed. They may be an underreported, but potentially serious, complication of phacoemulsification. Methods:We surveyed 114 cataract surgeons in Ontario to determine reported rates of second instrument tip breaks, their management, and presumed etiology.We reviewed 4 Toronto cataract centres for incident reports, instrument sterilization processes, and purchase histories. Using scanning electron microscopy (SEM), we compared the characteristics of a broken Sweeney tip to new and used second instruments. Results: Of the 35 surgeons responding to the survey, 34% had experienced a second instrument tip break during their careers. Approximately 73% (16 cases) of the 22 cases reported were managed successfully during the procedure by the primary surgeon, 14% (3 cases) required imaging by computerized tomography or x-ray, and another 14% (3 cases) required pars plana vitrectomy for tip retrieval. Purchase histories revealed that 1 Sweeney hook was exchanged monthly, equivalent to 100 to 150 surgeries. SEM of new and used second instruments revealed signs of metal fatigue on both new and used second instruments. Interpretation: Although both physicians and hospitals lack a method for ensuring quality control of second instruments, approximately one third of cataract surgeons encounter second instrument tip breaks during the course of their careers. Although most cases are managed intraoperatively, consistent hospital tracking records and standardized instrument inspection by institutions and surgeons are needed to determine how these complications occur and to establish protocols for complication reporting and management.
Persistent Identifierhttp://hdl.handle.net/10722/146302
ISSN
2015 Impact Factor: 1.46
2015 SCImago Journal Rankings: 0.685
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorNazemi, Fen_HK
dc.contributor.authorOdorcic, Sen_HK
dc.contributor.authorBragaMele, Ren_HK
dc.contributor.authorWong, Den_HK
dc.date.accessioned2012-04-10T01:50:04Z-
dc.date.available2012-04-10T01:50:04Z-
dc.date.issued2008en_HK
dc.identifier.citationCanadian Journal Of Ophthalmology, 2008, v. 43 n. 6, p. 702-706en_HK
dc.identifier.issn0008-4182en_HK
dc.identifier.urihttp://hdl.handle.net/10722/146302-
dc.description.abstractBackground: Second instrument tip breaks during phacoemulsification are complications that are anecdotally recalled, yet little information exists on why and how often they occur, whether they are consistently tracked, and how they are managed. They may be an underreported, but potentially serious, complication of phacoemulsification. Methods:We surveyed 114 cataract surgeons in Ontario to determine reported rates of second instrument tip breaks, their management, and presumed etiology.We reviewed 4 Toronto cataract centres for incident reports, instrument sterilization processes, and purchase histories. Using scanning electron microscopy (SEM), we compared the characteristics of a broken Sweeney tip to new and used second instruments. Results: Of the 35 surgeons responding to the survey, 34% had experienced a second instrument tip break during their careers. Approximately 73% (16 cases) of the 22 cases reported were managed successfully during the procedure by the primary surgeon, 14% (3 cases) required imaging by computerized tomography or x-ray, and another 14% (3 cases) required pars plana vitrectomy for tip retrieval. Purchase histories revealed that 1 Sweeney hook was exchanged monthly, equivalent to 100 to 150 surgeries. SEM of new and used second instruments revealed signs of metal fatigue on both new and used second instruments. Interpretation: Although both physicians and hospitals lack a method for ensuring quality control of second instruments, approximately one third of cataract surgeons encounter second instrument tip breaks during the course of their careers. Although most cases are managed intraoperatively, consistent hospital tracking records and standardized instrument inspection by institutions and surgeons are needed to determine how these complications occur and to establish protocols for complication reporting and management.en_HK
dc.languageengen_US
dc.publisherCanadian Ophthalmological Society. The Journal's web site is located at http://www.eyesite.ca/english/program-and-services/cjo/index.htmen_HK
dc.relation.ispartofCanadian Journal of Ophthalmologyen_HK
dc.subjectEquipment failureen_HK
dc.subjectEye foreign bodiesen_HK
dc.subjectIntraoperative complicationsen_HK
dc.subjectPhacoemulsificationen_HK
dc.subjectSiderosisen_HK
dc.subject.meshAnterior Eye Segment - Radiography - Surgeryen_US
dc.subject.meshDevice Removalen_US
dc.subject.meshEquipment Failure - Statistics & Numerical Dataen_US
dc.subject.meshEye Foreign Bodies - Radiography - Surgeryen_US
dc.subject.meshHealth Surveysen_US
dc.subject.meshHumansen_US
dc.subject.meshIntraoperative Complicationsen_US
dc.subject.meshMicroscopy, Electron, Scanningen_US
dc.subject.meshPhacoemulsification - Instrumentationen_US
dc.subject.meshQuality Controlen_US
dc.subject.meshQuestionnairesen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshTomography, X-Ray Computeden_US
dc.subject.meshVitrectomyen_US
dc.subject.meshX-Raysen_US
dc.titleSecond instrument tip breaks during phacoemulsificationen_HK
dc.typeArticleen_HK
dc.identifier.emailWong, D: shdwong@hku.hken_HK
dc.identifier.authorityWong, D=rp00516en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.3129/I08-148en_HK
dc.identifier.pmid19020637-
dc.identifier.scopuseid_2-s2.0-57749205733en_HK
dc.identifier.hkuros212103-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-57749205733&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume43en_HK
dc.identifier.issue6en_HK
dc.identifier.spage702en_HK
dc.identifier.epage706en_HK
dc.identifier.isiWOS:000262063900015-
dc.publisher.placeCanadaen_HK
dc.identifier.scopusauthoridNazemi, F=23568358800en_HK
dc.identifier.scopusauthoridOdorcic, S=8950294300en_HK
dc.identifier.scopusauthoridBragaMele, R=6506183538en_HK
dc.identifier.scopusauthoridWong, D=7401536078en_HK

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