In vivo architectural analysis of clear corneal incisions using anterior segment optical coherence tomography

J Cataract Refract Surg. 2009 Mar;35(3):444-50. doi: 10.1016/j.jcrs.2008.11.034.

Abstract

Purpose: To use anterior segment optical coherence tomography (AS-OCT) to analyze the in vivo architecture of clear corneal incisions after phacoemulsification using different techniques.

Setting: Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France.

Methods: This prospective observational study analyzed clear corneal incisions used in phacoemulsification. All wounds were evaluated 1 day and 8 days postoperatively by AS-OCT (Visante). Incision architecture and pachymetry at the wound level were analyzed.

Results: Thirty-five clear corneal incisions were analyzed. Six eyes had 2.75 mm coaxial phacoemulsification, 19 had 2.20 mm microincision coaxial phacoemulsification, and 10 had 1.30 mm bimanual microincision phacoemulsification. The 1.30 mm incision had a straight-line configuration. The 2.20 mm and 2.75 mm incisions had an arcuate configuration. The angles of incidence of 1.30 mm incisions were greater than those of 2.20 mm incisions (P<.001). All incisions had slight corneal edema limited to the incision area. The edema was slightly greater around 1.30 mm incisions (mean pachymetry 1143 microm +/- 140 [SD]) than around 2.20 mm incisions (mean 1012 +/- 101 microm) (P = .001). Bimanual procedures had satisfactory endothelial apposition in the enlarged areas, where stromal edema was less than that surrounding the unenlarged 1.30 mm incisions.

Conclusions: The 3 phacoemulsification techniques induced gaping of the endothelial edge, minor inadequate endothelial apposition, and mild stromal edema in the area of the clear corneal incisions. Bimanual microincision sleeveless phacoemulsification may alter the wound slightly more than coaxial 2.75 mm and microcoaxial 2.20 mm sleeved-tip phacoemulsification.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anterior Eye Segment
  • Cornea / pathology*
  • Cornea / surgery*
  • Female
  • Humans
  • Lens Implantation, Intraocular
  • Male
  • Microsurgery / methods
  • Middle Aged
  • Phacoemulsification*
  • Prospective Studies
  • Tomography, Optical Coherence / methods*
  • Wound Healing*