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Yassine J. Daoud, Yasin A. Khan, Renata T. Kashiwabuchi, stephen M. tracy, Esen K. Akpek, walter stark, Ashley Behrens, Peter J. McDonnell, III; Prospective Analysis of Side Port Incision Morphology in the Early Postoperative Period: Examining the Relationship Between Axial Length and Wound Gaping. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6236.
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Surgical wound gaping is a risk factor for the development of post-operative endophthalmitis, and it has become especially relevant since the advent of sutureless clear corneal incisions used in phacoemulsification and intraocular lens implantation (CE/IOL). In this study, we evaluate the early post-operative integrity of the port incisions created during CE/IOL, the incidence of gaping and the factors that may relate to wound instability.
40 eyes from 40 patients after uncomplicated CE/IOL were included. All patients underwent a standard exam on the first day after surgery; slit-lamp exam was performed and intraocular pressure (IOP) was measured. Optical coherence tomography (OCT) was performed to visualize the side port incisions, and to detect and measure the degree of gaping. The relationships between incision gaping and patient age, IOP and axial length (AL) were analyzed.
Although incision gaping was not visible on slit-lamp exam, OCT revealed side port incision gaping in 10 out of 40 (25%) patients. The average proportion of gaping, relative to the length of the incision was 21.8% and ranged from 9.1 to 40.1%. There was no statistically significant effect of age or post-operative IOP on gaping. There was a statistically significant relationship between the axial length and side port incision gaping(P<0.05). Linear regression indicated a mild, but significant correlation between AL and the degree of port incision gaping (r2=0.15, p=0.0153), with longer eyes having higher risk for postoperative gaping.
Side port incisions are susceptible to varying degrees of gaping in the early post-operative period, possibly representing an overlooked portal for intraocular contamination. The presence of gaping in the port incision is significantly correlated with AL.
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