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Record W2099536020 · doi:10.1016/j.jcrs.2009.08.027

Chopper and side-port incision leakage

2010· letter· en· W2099536020 on OpenAlexaff
Devesh Varma, Iqbal Ike K. Ahmed

Bibliographic record

VenueJournal of Cataract & Refractive Surgery · 2010
Typeletter
Languageen
FieldMedicine
TopicIntraocular Surgery and Lenses
Canadian institutionsToronto Public Health
Fundersnot available
KeywordsMedicineLeakage (economics)SurgeryCataract surgeryPhacoemulsificationChopperEngineeringVisual acuityElectrical engineering

Abstract

fetched live from OpenAlex

Liyanage et al.1 should be commended for attempting to study incisional leakage and potential anterior chamber stability during cataract surgery, although the latter was not formally studied. Unfortunately, the study has several methodological issues, including a very rudimentary method to measure irrigation and aspiration volume (graduations on irrigation bottle and aspiration bag, respectively). Measuring volume differences using a strain gauge might have been more precise. Our biggest concern is in the second part of the study in which the maintenance of a chopping instrument within the side port and its impact on incision leakage was evaluated. Fluid loss between 2 different surgeons (one who removed the chopper after chopping and one who did not) was compared. Although incision sizes were apparently similar, numerous confounding variables probably made the results less meaningful. Confounders that were not reported or controlled include specific machine settings (bottle height, flow/vacuum settings, power modulation), bed height, surgical styles (handling of chopper, maneuvers), hand positioning, cataract density, phaco times, intraocular lens model and size, and surgeon skill. While we assume neither surgeon used continuous irrigation, one surgeon might have been in foot position 2 between chopping/lens manipulations, while the other surgeon might have preferred foot position 1; this can dramatically alter the measured incision leakage. Furthermore, with such a small number of cases assessed (11 in one group and 16 in the other), a spurious result is highly possible. The scatterplot presented is misleading because data appear to be presented as paired data when, in fact, they are not. Although a percentage score of incision leakage was used to negate variable surgical times, other factors as discussed above could have exerted a confounding effect on the results. Furthermore, it might have been better to measure fluid inflow and outflow during only the phacoemulsification portion of the procedure to more accurately assess differences in side-port instrumentation techniques. Although the authors raised some important considerations in phaco technique, we would encourage a more robust and controlled method of analyzing the impact of side-port instrumentation. A second instrument can provide stability for the eye during topical surgery, and many surgeons find it helpful in carouseling nuclear fragments at the phaco tip. This permits greater efficiency, less turbulence, and reduced case times, as well as improved fluidic and phacoemulsification metrics. To reduce the potential for excessive leakage from side-port incisions, we advocate a smaller side-port incision with a trapezoidal design (1.0 mm external incision and 0.5 mm internal incision) to prevent oar locking but with less leakage and using the incision as fulcrum to reduce tissue trauma.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Research integrity
Consensus categoriesResearch integrity
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: none
Teacher disagreement score0.296
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.002
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0020.001
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.001
Open science0.0000.000
Research integrity0.0020.012
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.019
GPT teacher head0.272
Teacher spread0.253 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; both teacher heads agree on what is shown here.

Study designNot applicable
Domainnot available
GenreCommentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations4
Published2010
Admission routes1
Has abstractyes

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