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Use of P1-P4 Purkinje reflections as a surrogate sign for intraoperative patient fixation. | LitMetric

Use of P1-P4 Purkinje reflections as a surrogate sign for intraoperative patient fixation.

J Cataract Refract Surg

From Vance Thompson Vision, Sioux Falls, South Dakota (Thompson), Department of Ophthalmology, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota (Thompson), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas (Holladay), Centricity Vision Inc., Carlsbad, California (Sretavan).

Published: December 2021

AI Article Synopsis

  • Circumferential and even overlap of the anterior capsule helps stabilize intraocular lenses and reduces the risk of posterior capsular opacification, leading to better outcomes for cataract patients.
  • *P1 and P4 Purkinje reflections can serve as markers for correctly centering the capsulotomy, though patient fixation can be challenging during surgery.
  • *This study shows that the relative positions of P1 and P4 reflections can be monitored intraoperatively to aid in maintaining appropriate capsulotomy centration even when patient fixation is difficult.

Article Abstract

Circumferential, even anterior capsular overlap maximizes intraocular lens stability and posterior capsular opacification mitigation and provides best long-term outcomes for the cataract patient. P1 and P4 Purkinje reflections at patient fixation may provide a reliable marker for capsulotomy centration. However, patient fixation may be hindered during surgery because of anesthesia or light sensitivity. In this study, we demonstrate that the relationship between the P1 and P4 Purkinje reflections previewed prior to surgery when the patient is fixating may be recreated intraoperatively if fixation becomes difficult. The final position of P1 and P4 relative to one another at fixation is invariant in a given patient, but there are variations among patients. Knowledge of the P1 and P4 relationship can be used as a surrogate sign of patient fixation to assist in capsulotomy centration during cataract surgery.

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Source
http://dx.doi.org/10.1097/j.jcrs.0000000000000805DOI Listing

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