Journal List > J Korean Ophthalmol Soc > v.54(6) > 1009699

J Korean Ophthalmol Soc. 2013 Jun;54(6):877-886. Korean.
Published online June 14, 2013.  https://doi.org/10.3341/jkos.2013.54.6.877
Copyright © 2013 The Korean Ophthalmological Society
The Morphological Changes in Main Corneal Incision (2.2 mm vs. 2.8 mm) Evaluated Using Anterior Segment Optical Coherence Tomography
Jin Hyung Kim, MD, Tae Im Kim, MD, PhD, Eung Kweon Kim, MD, PhD and Hyung Keun Lee, MD
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.

Address reprint requests to Hyung Keun Lee, MD. Department of Ophthalmology, Gangnam Severance Hospital, #211 Eonju-ro, Gangnam-gu, Seoul 135-720, Korea. Tel: 82-2-2019-3440, Fax: 82-2-3463-1049, Email: shadik@yuhs.ac
Received June 22, 2012; Revised January 03, 2013; Accepted April 15, 2013.

Abstract

Purpose

To investigate wound characteristics and ultrastructural changes in the 2.2-mm and 2.8-mm main corneal incisions.

Methods

Forty-four eyes of 34 patients undergoing cataract surgery were randomized to receive a 2.2-mm or 2.8-mm main corneal incision. All incisions were evaluated 1, 7, and 30 days postoperatively using anterior segment optical coherence tomography. The angle, length, maximal thickness of the incision, and if present, corneal gap length and incision gap area were calculated. The existence of Descemet's membrane detachment was recorded.

Results

The mean endothelial gap length and gap area of the 2.2-mm wound were larger than the 2.8-mm, with the only statistically significant difference observed on postoperative day 30 (p = 0.015 and 0.027, respectively). There was no difference in the mean incision angle, length, and corneal thickness between the 2 incision sizes. The ratio of Descemet's membrane detachment increased with older age and low postoperative IOP, but not associated with incision size (p < 0.05).

Conclusions

Both the 2.2-mm and 2.8-mm main corneal incisions showed excellent wound healing outcome without significant postoperative complications. Older patients with low postoperative IOP required a more careful wound care management. The incision parameters in the present study can be used as an indicator of the healing process to reduce wound-related complications.

Keywords: Anterior segment optical coherence tomography; Main corneal incision; Morphology; Phacoemulsification

Figures


Figure 1
Anterior segment OCT (optical coherence tomography) image showing a clear corneal incision site postoperatively. The definition of incision site parameters: 1) Incision angle (The angle between the line that joins the epithelial and endothelial ends of the incision and the tangential line on the corneal surface) 2) Incision length (The total length of the main incision measured from the wound entry to its exit point) 3) Epithelial/endothelial gap length (The length that lines inside of the gap, the longer one is selected, if present) 4) Epithelial/endothelial gap area (The area inside of the gap, if present) 5) Descemet's membrane detachment 6) Maximal corneal thickness at the incision site.
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Figure 2
Results of AS-OCT parameter, (A) Mean angle (°); (B) Mean length (µm); (C) Mean corneal thickness at incision site (µm); (D) Mean endothelial gap length (µm); (E) Mean endothelial gap area (µm2) (*p < 0.05).
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Figure 3
The ratio of postoperative Descemet's membrane detachment by age (*p < 0.05).
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Tables


Table 1
Preoperative patient characteristics
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Table 2
Comparison of mean surgical parameters between 2.2-mm and 2.8-mm incision group
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Table 3
Postoperative changes in mean UCVA and IOP and astigmatism by autorefractor
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Table 4
Results of AS-OCT parameters
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Table 5
The ratio of postoperative Descemet's membrane detachment by age
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Table 6
Parameters of groups with and without Descemet's membrane detachment
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