Wound Architecture of Clear Corneal Incision With or Without Stromal Hydration Observed With 3-Dimensional Optical Coherence Tomography

• Published in: American journal of ophthalmology Vol. 151; no. 3; pp. 413 - 419.e1
• Main Authors: Fukuda, Shinichi, Kawana, Keisuke, Yasuno, Yoshiaki, Oshika, Tetsuro
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2011; Elsevier; Elsevier Limited
• Subjects: Aged; Architecture; Biological and medical sciences; Body Water - metabolism; Cataracts; Cornea - pathology; Cornea - surgery; Corneal Edema - diagnosis; Corneal Edema - metabolism; Corneal Stroma - metabolism; Corneal Stroma - pathology; Eye surgery; Female; Hospitals; Humans; Imaging, Three-Dimensional; Lens Implantation, Intraocular; Male; Medical sciences; Miscellaneous; Ophthalmology; Phacoemulsification - methods; Prospective Studies; Standard deviation; Studies; Surgery; Surgical Wound Dehiscence - diagnosis; Surgical Wound Dehiscence - prevention & control; Time Factors; Tomography, Optical Coherence; Wound Healing; Incision; Cornea; Hydration; Optical coherence tomography; Stroma; Ophthalmology; Wound
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2010.09.010

Purpose To evaluate wound architectures of a clear corneal incision and the duration of stromal edema caused by intentional hydration in cataract surgery using 3-dimensional (3-D) cornea and anterior segment optical coherence tomography (OCT). Design Prospective, randomized study. Methods On 30 eyes of 23 patients, cataract surgery was performed through a clear corneal incision created with a 2.4-mm blade. After confirming the water tightness of the clear corneal incision at the end of surgery, 15 randomly selected eyes received stromal hydration, and the remaining 15 eyes did not. Using the 3-D cornea and anterior segment optical coherence tomography, wound architecture was assessed 1 day, 1 week, and 2 weeks after surgery. Results There was a statistically significant difference in corneal thickness at the clear corneal incision between eyes with and without stromal hydration 1 day and 1 week after surgery ( P < .001 and P < .05, Mann–Whitney U test), but not at 2 weeks after surgery. On day 1, gaping at the epithelial side was seen in 6.7% (2 eyes), gaping at the endothelial side in 30% (9 eyes), misalignment of the roof and floor of incision in 40% (12 eyes), and local detachment of Descemet membrane in 36.7% (11 eyes). These imperfections improved with time. Conclusions Using the 3-D cornea and anterior segment optical coherence tomography, detailed architectures of the clear corneal incision were investigated. It was found that the effect of stromal hydration lasted for at least 1 week after surgery.