Optical coherence tomography of the effects of stromal hydration on clear corneal incision architecture
Received 26 January 2009; received in revised form 9 March 2009; accepted 10 March 2009.
Purpose
To evaluate the effects of stromal hydration on clear corneal incision (CCI) architecture immediately after surgery using anterior segment optical coherence tomography (AS-OCT).
Setting
Department of Ophthalmology, Royal Berkshire Hospital, Reading, United Kingdom.
Methods
Clear corneal incisions in adult eyes were examined using a Visante AS-OCT imaging system within 1 hour of surgery. Half the CCIs had stromal hydration with a balanced salt solution and half did not. Incisions were made with a 2.75 mm steel keratome. Intraocular pressure (IOP) was measured within 90 minutes after surgery. The CCI length and corneal thickness at the CCI site were measured using software built into the AS-OCT system.
Results
Thirty CCIs were evaluated. Stromal hydration significantly increased the measured CCI length (P<.05, t test); this was the result of a trend toward increased corneal thickness at the CCI site with hydration (P<.1, t test). The mean CCI length was 1.69 mm ± 0.27 (SD) (range 1.31 to 2.32 mm) with hydration and 1.51 ± 0.23 mm (range 1.30 to 1.95 mm) without hydration. The mean IOP was 20.9 ± 8.18 mm Hg and 15.8 ± 8.20 mm Hg, respectively. The IOP tended to be higher with hydration (P<.1, t test). Local detachment of Descemet membrane was more likely with stromal hydration (63%) than without (25%).
Conclusion
Stromal hydration significantly increased CCI length and tended to leave the eye with a higher early postoperative IOP, showing the importance of taking stromal hydration into account when designing similar OCT studies of CCI architecture.
From the Department of Ophthalmology, Royal Berkshire Hospital, Reading, and the Prince Charles Eye Unit, King Edward VII Hospital, Windsor, United Kingdom
Corresponding author: Mr. Daniel Calladine, Ophthalmology Department, Royal Berkshire NHS Foundation Trust, London Road, Reading RG1 5AN, United Kingdom.
Neither author has a financial or proprietary interest in any material or method mentioned.
Presented at the XXVI Congress of the European Society of Cataract & Refractive Surgeons, Berlin, Germany, September 2008, and the United Kingdom & Ireland Society of Cataract and Refractive Surgeons, Brighton, United Kingdom, November 2008.
ABSTRACT