June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Prospective observational study for conjunctival scar after phacoemulsification.
Author Affiliations & Notes
  • Makoto Gozawa
    Ophthalmology, University of Fukui, Yishida Fukui, Japan
  • Yoshihiro Takamura
    Ophthalmology, University of Fukui, Yishida Fukui, Japan
  • Seiji Miyake
    Ophthalmology, University of Fukui, Yishida Fukui, Japan
  • Satoshi Yokota
    Ophthalmology, University of Fukui, Yishida Fukui, Japan
    Ophtlalmology, University of Kyoto, Kyoto, Japan
  • Masanori Sakashita
    Ophthalmology, University of Fukui, Yishida Fukui, Japan
  • Masaru Inatani
    Ophthalmology, University of Fukui, Yishida Fukui, Japan
  • Footnotes
    Commercial Relationships Makoto Gozawa, None; Yoshihiro Takamura, None; Seiji Miyake, None; Satoshi Yokota, None; Masanori Sakashita, None; Masaru Inatani, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 2676. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Makoto Gozawa, Yoshihiro Takamura, Seiji Miyake, Satoshi Yokota, Masanori Sakashita, Masaru Inatani; Prospective observational study for conjunctival scar after phacoemulsification.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2676.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: Conjunctival scar after lens extraction is a risk factor for the surgical failure of trabeculectomy. We examined whether conjunctival incision during phacoemulsification caused conjunctival scar.

Methods: Transscleral Phacoemulsification was performed with superior conjunctival incision in 25 eyes (the superior group) and temporal conjunctival incision in 25 eyes (the temporal group). Anterior segment optical coherence tomography (AS-OCT) image in the superior conjunctiva was taken before, and at 1 week, 1, 3, and 6 months after surgery. We quantified the length of 3 layers; epithelium, stroma and Tenon’s capsule layers in the superior conjunctiva. We defined the length of the layers / 3 mm x 100% as the preserved rate. It was compared between the superior group and the temporal group. The relationship between OCT image and histology was evaluated with the rabbit conjunctiva after phacoemulsification.

Results: Despite of no significant difference (p=1.0) between the 2 groups before surgery, the preserved rates after surgery were significantly (p<0.0001) lower in the superior group than the temporal group (60 ± 2% vs 100 ± 0% at 1 week, 52 ± 5% vs 99 ± 1% at 1 month, 63 ± 2% vs 100 ± 0% at 3 months, 61 ± 3% vs 100 ± 0% at 6 months, respectively). AS-OCT image for the rabbit phacoemulsification model also demonstrated significantly (p<0.0001) less preserved rates in the conjunctival lesion with surgical incision than the lesion without surgical incision at 1 day (39 ± 4% vs 100 ± 0%), 7 days (49 ± 9 % vs 100 ± 0%) and 1 month (35 ± 3% vs 100 ± 0%). The thickness of the conjunctiva was significantly higher in the lesion with surgical incision than the lesion without surgical incision on 1 day (347 ± 32 mm vs 217 ± 16 mm, p<0.05) and 7 days (363 ± 36 mm vs 216 ± 15 mm, p<0.01). The densities of neutrophils and α-SMA-positive cells were significantly higher in the lesion with surgical incision than the lesion without incision on 1 day (4913 ± 839 / mm2 vs 59 ± 20 / mm2, p=0.0001) and 7 days (8967 ± 876 / mm2 vs 1259 ± 91 / mm2, p=0.0001), respectively.

Conclusions: Conjunctival incision during phacoemulsification disturbs the 3-layer structure in the conjunctiva. The disturbance corresponds to the conjunctival wound healing process. Temporal incision during phacoemulsification may contribute to the surgical success of trabeculectomy because the 3-layer structure in the superior conjunctiva is unaffected.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×