In vivo architectural analysis of clear corneal incisions using anterior segment optical coherence tomography
Received 11 July 2008; received in revised form 5 November 2008; accepted 12 November 2008.
Purpose
To use anterior segment optical coherence tomography (AS-OCT) to analyze the in vivo architecture of clear corneal incisions after phacoemulsification using different techniques.
Setting
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 μm ± 140 [SD]) than around 2.20 mm incisions (mean 1012 ± 101 μm) (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.
From Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (Dupont-Monod, Labbé, Fayol, Chassignol, Baudouin) and Université Paris Descartes (Bourges), Assistance Publique des Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, and Hôpital Ambroise Paré (Labbé, Baudouin), Assistance Publique des Hôpitaux de Paris, Boulogne, Université Paris Ile-de-France Ouest, Versailles, France
Corresponding author: Christophe Baudouin, MD, PhD, Service d'Ophtalmologie III, C.H.N.O. des Quinze-Vingts, 28 rue de Charenton, 75012 Paris, France.
No author has a financial or proprietary interest in any material or method mentioned.
Presented in part as a poster at the annual meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, USA, May 2008.
Supported by Quinze-Vingts National Ophthalmology Hospital, Paris, France.
ABSTRACT