Purpose:
The ability of a surgeon to prospectively predict the post-operative IOP course of patients undergoing phacoemulsification would greatly enhance ophthalmic care. This study was designed to evaluate how wound construction technique influences the IOP-lowering effect of modern cataract surgery, specifically the comparison of clear cornea incision (CC), clear cornea incision with a suture (CCS), and scleral tunnel (ST).
Methods:
A retrospective review of phacoemulsification procedures at the Aston Clinic of the University of Texas Southwestern Medical Center between 2006-2010 was performed. Data were compiled regarding age, race, ophthalmic conditions and medications, pre-operative IOP, pre-operative spherical equivalent, axial length, operative details, and post-operative IOP (at 1 week, 1 month, 3 months, 6 months, and 1 year). Analyses comparing post-operative IOP were then performed.
Results:
Initial review resulted in evaluation of 419 eyes from the charts of 299 patients. Mean pre-operative IOP was 16.9 mmHg. The decrease in IOP was on average 2.0 mmHg across all follow-up periods, which was significantly lower at each respective follow-up point (p < 0.01). There was no significance between decrease in IOP when the incision-type groups were compared against each other.
Conclusions:
The clear cornea incision group (range, 2.2-2.5 mmHg) had significantly lower IOP measurements at all follow-up visits, but the clear cornea with suture and scleral tunnel groups were less consistent. Although not significant, the clear cornea group had a greater decrease in IOP post-operatively compared to the other groups.
Keywords: cataract • intraocular pressure • wound healing