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


METHODS
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.
Dupont-Monod
Sylvère
S
Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Université Paris Descartes, Assistance Publique des Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, France.
Labbé
Antoine
A
Fayol
Nicolas
N
Chassignol
Alexis
A
Bourges
Jean-Louis
JL
Baudouin
Christophe
C
D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment; D003315:Cornea / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D018918:Phacoemulsification; D011446:Prospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014945:Wound Healing