title: Early changes in morphology and intraocular pressure by size of clear corneal incision.
abstract: OBJECTIVE
  We compared changes in morphology and intraocular pressure (IOP) induced by clear 2.2-mm and 3.0-mm corneal incisions in a cohort of patients with cataracts.
  
  
  METHODS
  In 160 eyes (from 70 men and 90 women at the Ophthalmic Center of Sun Yat-sen University), optical coherence tomography and tonometry were performed at 1, 5, and 24 hours after cataract surgery. The main outcome measures were IOP, postoperative changes in Descemet membrane detachment (DMD), healing of the surgical incision, and inflammation of the anterior chamber.
  
  
  RESULTS
  Five hours after surgery, patients with 2.2-mm and 3.0-mm incisions had lower IOPs (P < 0.017) as measured by noncontact tonometry, but the difference was significant only among patients with grade V cataracts (2.2 mm, 12.6 ± 1.2 mm Hg; 3.0 mm, 14.5 ± 0.9 mm Hg, P < 0.05). The incidence of endothelial gap at 24 hours after surgery was significantly higher in the 2.2-mm (50%) versus 3.0-mm (11.1%) group of patients with grade V cataracts (P < 0.05). The incidence of DMD at 5 hours was also significantly higher in the 2.2-mm group (75%) than in the 3.0-mm group (22.2%) only among patients with this grade (P < 0.05).
  
  
  CONCLUSIONS
  Incision width made no difference among patients with grade I-IV lens nuclei; but among those with grade V, 3.0-mm incisions had significantly less endothelial gaping, less DMD, and higher mean IOPs. For these patients, smaller incisions may not be optimal, and eyes may be especially vulnerable within 5 hours of surgery.
authors.affiliation: Cataract Department, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Cheng
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.forename: Yizhi
authors.initials: Y
authors.lastname: Liu
authors.forename: Bin Bin
authors.initials: BB
authors.lastname: Xie
authors.forename: Lei
authors.initials: L
authors.lastname: Xi
authors.forename: Ye
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000368:Aged; D003315:Cornea / Q000473:pathology* / Q000601:surgery*; D003886:Descemet Membrane / Q000473:pathology; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D019591:Pseudophakia / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014606:Uveitis, Anterior / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing / Q000502:physiology