Abstract
Purpose: :
To evaluate corneal incisions after cataract surgery using high resolution optical coherence tomography at early postoperative period.
Methods: :
A series of 15 patients were evaluated in the study using the Visante OCT (Carl Zeiss Meditec, Dublin, CA) in a high-resolution cornea mode. The peripheral area of the cornea at angles between 120-160 degrees for clear corneal incisions and 30-70 degrees for the side port incision were imaged. Clear corneal incisions were performed with either 2.6 mm or 2.75 mm keratomes (Alcon, Fort Worth, TX) and side port incisions with 15-degree blades (Alcon). Clear corneal incisions were created following a stepped, biplanar approach. All surgeries were performed using an Infiniti Vision System with an Ozil torsional handpiece and a 0.9 mm, 45 degrees Kelman tip. A C cartridge in a Monarch II injector was used for IOL insertion. The same experienced surgeon performed all surgeries (AB). Eyes were screened at 24 h and 7-10 days postoperative.
Results: :
High resolution OCT images were obtained in all cases. 80% of clear corneal incisions showed some degree of Descemet’s membrane detachment. These detachments varied from evident to subtle. Gaping of the clear corneal wound was observed in 40% patients in some areas of the corneal tunnel. Gaping was also observed at the port incision, as well as Descemet’s detachment in those wounds.
Conclusions: :
Corneal incisions after cataract surgery showed a dramatic incidence in Descemet’s detachment and gaping. Side port incisions seem to show similar behavior after cataract surgery when compared to clear corneal incisions, which may possibly have a role in extraocular fluid inflow and endophthalmitis after cataract surgery.
Keywords: endophthalmitis • cataract • wound healing