title: The clear corneal tongue: a mechanism for wound incompetence after phacoemulsification.
abstract: OBJECTIVE
  To describe a mechanism for wound incompetence after phacoemulsification with corneal incisions resulting in early postoperative wound leakage.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  Three patients who had uneventful phacoemulsification through a clear corneal incision were identified because of a postoperative wound leak. A corneal tongue, consisting of an everted triangular flap of posterior corneal stroma, the Descemet membrane, and endothelium, was observed in the wounds of all cases.
  
  
  RESULTS
  One wound leak resolved after pressure patching. The other two necessitated wound revisions. None of the patients developed endophthalmitis.
  
  
  CONCLUSIONS
  In phacoemulsification with corneal incisions, an everted flap of posterior corneal tissue, a corneal tongue, may prevent normal anatomical apposition of the surgical wound edges leading to potential wound incompetence. This event may increase the risk of endophthalmitis after clear corneal phacoemulsification.
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Diamond Y
authors.initials: DY
authors.lastname: Tam
authors.forename: M Reza
authors.initials: MR
authors.lastname: Vagefi
authors.forename: Ayman
authors.initials: A
authors.lastname: Naseri
mesh_terms: D000368:Aged; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging; D003315:Cornea / Q000601:surgery*; D009877:Endophthalmitis / Q000209:etiology; D006801:Humans; D008297:Male; D033401:Microscopy, Acoustic; D018918:Phacoemulsification; D013524:Surgical Flaps / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000000981:diagnostic imaging / Q000209:etiology*; D014945:Wound Healing