April 2010
Volume 51, Issue 13
ARVO Annual Meeting Abstract  |   April 2010
Sutured Step Clear Corneal Incision: Wound Apposition and Permeability to Bacterial Sized Particles
Author Affiliations & Notes
  • W. N. May
    Ophthalmology, University of Southern California, Whittier, California
  • H. Hertzog
    Loma Linda University, Loma Linda, California
  • J. Castro Combs
    Ophthalmology, Johns Hopkins University, Owings Mills, Maryland
  • R. T. Kashiwabuchi
    Ophthalmology, Johns Hopkins Univ Wilmer Eye Inst, Baltimore, Maryland
  • W. Tattiyakul
    Ophthalmology, Johns Hopkins University, Baltimore, Maryland
  • S. Qureshi-Said
    Ophthalmology, Johns Hopkins University, Baltimore, Maryland
  • A. Behrens
    Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland
  • Footnotes
    Commercial Relationships  W.N. May, None; H. Hertzog, None; J. Castro Combs, None; R.T. Kashiwabuchi, None; W. Tattiyakul, None; S. Qureshi-Said, None; A. Behrens, None.
  • Footnotes
    Support  May Vision Foundation (Los Angeles, CA). Unrestricted grant from Research to Prevent Blindness (New York, NY) to the Wilmer Eye Institute of the Johns Hopkins University School of Medicine, the Resear
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 5451. doi:
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      W. N. May, H. Hertzog, J. Castro Combs, R. T. Kashiwabuchi, W. Tattiyakul, S. Qureshi-Said, A. Behrens; Sutured Step Clear Corneal Incision: Wound Apposition and Permeability to Bacterial Sized Particles. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5451.

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

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Purpose: : To determine the effects of single radial or horizontal suture placement in two-step clear cornea incision (CCI) wound apposition and permeability to particles of India ink.

Methods: : Five human globes were employed. Two 25-gauge needles connected to a saline solution bag and to a digital manometer were inserted through the limbus 120° apart. Four two-step CCIs (2.75 mm wide, and 3 mm length) were constructed in each cornea. Incisions were divided in three groups: single radial suture (SRS), single horizontal suture (SHS), and unsutured group. Optical coherence tomography was performed before and after suture placement. Finally, with a preset 10 mmHg intra ocular pressure (IOP), India ink was applied to the incision site and a sudden IOP fluctuation was induced. Inflow was outlined and measured by planimetry.

Results: : The area and linear distance of India ink inflow after pressure challenge in all study groups were higher when compared to pre-pressure measurements, however this increase was only significant in the SRS group (p= 0.038). Additionally, SRS placement significantly increased inner wound gapping (p= 0.007). Though SHS also widened inner wound gaping, this increase was not significant (p= 0.180)

Conclusions: : Single radial suture placement increased inner wound gaping and inflow of India ink. Horizontal suture and even no suturing at all are better to assure wound patency and to decrease inflow of extraocular particles after sudden changes in IOP in our ex-vivo human model. These results may have impact in the incidence of postoperative bacterial inflow after cataract surgery.

Keywords: cataract • microbial pathogenesis: experimental studies 

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