Structural Analysis of Different Incision Sizes and Stromal Hydration in Cataract Surgery Using Anterior Segment Optical Coherence Tomography.
- Author:
Jong Wook BANG
1
;
Jong Hyun LEE
;
Jin Hyoung KIM
;
Do Hyung LEE
Author Information
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords: Corneal pachymetry; Corneal stroma; Wounds and injuries
- MeSH: Aged; Anterior Eye Segment; Cataract Extraction/*methods; Corneal Stroma/pathology/*surgery; Female; Humans; Male; Middle Aged; Surgical Wound Dehiscence/diagnosis/*prevention & control; Tomography, Optical Coherence/*methods; *Wound Healing
- From:Korean Journal of Ophthalmology 2015;29(1):23-30
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To analyze healing changes of corneal wounds of different corneal incision sizes with or without stromal hydration in cataract surgery using anterior segment optical coherence tomography. METHODS: Cataract surgeries were performed by a single surgeon and 2.2- and 2.8-mm corneal incisions were made using a diamond blade (ME-759; Meyco, Biel-Bienne, Swiss). Patients were divided into four groups according to incision size (2.2 and 2.8 mm), and with/without stromal hydration. Fifteen eyes were assigned to each group and incision wounds were measured using anterior segment optical coherence tomography at 2 hours, 1 day, 1 week, 1 month, and 3 months postoperatively. Corneal thickness, incision length and incision angle were measured and existence of epithelial, endothelial gaping and Descemet's membrane detachment was evaluated. RESULTS: Incision thickness was greater in the group with stromal hydration than in the group without on operation day (p < 0.05). Stromal hydration exerted greater influence in the 2.2-mm incision group than in the 2.8-mm incision group. Corneal thickness decreased more rapidly in the stromal hydration group than in the group with no hydration (p = 0.022). Endothelial gaping was greater in the 2.2-mm incision group than in the 2.8-mm incision group 1 day, 1 month, and 3 months after surgery (p = 0.035, p = 0.009, and p = 0.008, respectively). No other statistical significance was observed between the two groups (2.2 and 2.8 mm) during follow-up regarding corneal thickness, epithelial gaping and Descemet's membrane detachment. CONCLUSIONS: Corneal wounds with a smaller incision could be more vulnerable to external stimuli such as stromal hydration and are less stable than those with a larger incision.
