title: Bacterial-sized particle inflow through sutured clear corneal incisions in a laboratory human model.
abstract: OBJECTIVE
  To determine the effectiveness of a single radial suture placement in 2 clear corneal incision (CCI) configurations in preventing inflow of bacterial-sized particles.
  
  
  METHODS
  Wilmer Eye Institute, Baltimore, Maryland, USA.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  Ten human globes were used. Two 25-gauge needles connected to a saline solution bag and to a digital manometer were inserted through the limbus 120 degrees apart. Four incision-suture combinations were evaluated sequentially in each cornea. All incisions had the same dimensions (2.75 mm width, 3.00 mm length). Two incisions were single plane, and 2 were biplane. One incision from each configuration was left unsutured, and the other was sutured (10-0 nylon). With a preset 10 mm Hg intraocular pressure (IOP), India ink was applied to the incision site and a sudden IOP fluctuation was induced. Inflow was outlined and measured by planimetry.
  
  
  RESULTS
  There was a significant increase in area and linear distance of India-ink inflow after pressure challenge in all groups (P < .05), but with important differences among them. When the sutured and unsutured groups from each CCI were compared, there was a significantly smaller area of inflow in the 2-step unsutured group (P < .05). The linear inflow was higher in both sutured groups; however, the difference was significant for the 2-step incision configuration only (P < .05).
  
  
  CONCLUSIONS
  A single radial suture reduced the area of inflow of bacterial-sized particles but increased the linear distance of inflow in single-plane 3.0 mm incisions. Suture placement in a stepped incision increased inflow of bacterial-sized particles.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. williamnmaymd@gmail.com
authors.forename: William N
authors.initials: WN
authors.lastname: May
authors.forename: Juan
authors.initials: J
authors.lastname: Castro-Combs
authors.forename: Renata T
authors.initials: RT
authors.lastname: Kashiwabuchi
authors.forename: Hans
authors.initials: H
authors.lastname: Hertzog
authors.forename: Woranart
authors.initials: W
authors.lastname: Tattiyakul
authors.forename: Yasin A
authors.initials: YA
authors.lastname: Kahn
authors.forename: Flavio
authors.initials: F
authors.lastname: Hirai
authors.forename: Emily W
authors.initials: EW
authors.lastname: Gower
authors.forename: Ashley
authors.initials: A
authors.lastname: Behrens
mesh_terms: D002244:Carbon / Q000378:metabolism*; D002387:Cataract Extraction; D003315:Cornea / Q000378:metabolism* / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008954:Models, Biological; D009757:Nylons; D013529:Surgical Wound Dehiscence / Q000378:metabolism*; D013536:Suture Techniques; D013537:Sutures; D014945:Wound Healing / Q000502:physiology
chemical_list: D009757:Nylons; C028433:chinese ink; D002244:Carbon