Research Article

Wound architectural analysis of 1.8mm microincision cataract surgery using spectral domain OCT

Benedito Antonio de Sousa, Anderson Teixeira*, Camila Salaroli, Nonato Souza and Lucy Gomes

Published: 08/12/2019 | Volume 3 - Issue 2 | Pages: 008-012

Abstract

Purpose: Analyze Microincision Cataract surgery wound using Fourier-Domain optical coherence tomography.

Setting: Medical School of Medicine, Catholic University of Brasilia, Brasília, Brazil.

Design: Prospective comparative observational study.

Methods: Forty eyes were included in this prospective study divided in two groups: with contact lens (CL) and without contact lens (WCL). A line scan pattern of the corneal incisions were acquired using a Spectral domain OCT system immediately after the surgery, and at postoperative days 1, 7 and 30. Incisions were analyzed regarding length, location, angle, architecture, and anatomic imperfections.

Results: All incisions were located temporal or nasal superiorly. The average wound length was 1.28 + 0.18mm and the mean incision angle was 49 + 9 degrees. The average wound length of the WCL group mean was 1.24 + 0.17 mm and the mean incision angle was 51 + 8 degrees. Comparing groups for the length and the angle, the incisions measurements were not statistically significant. Anatomic imperfections were observed at the first day postoperative in 12 eyes for CL group and in 13 eyes for the WCL group. No patient presented endophthalmitis during the follow-up.

Conclusion: Epithelial imperfection was observed in two patients in the WCL group with spontaneous resolution. The CL group had the highest length and lowest angle of corneal incision. Using contact lens to prevent wound construction imperfection appears not to be a good option. Further studies using a greater number of patients with an architectural analysis of clear corneal incisions are needed to confirm these preliminary results.

Read Full Article HTML DOI: 10.29328/journal.ijceo.1001020 Cite this Article

References

  1. Lee KM, Kwon HG, Joo CK. Microcoaxial cataract surgery outcomes: comparison of 1.8 mm system and 2.2 mm system. J Cataract Refract Surg. 2009; 35: 874-880. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19393887
  2. Long DA, Monica ML. A prospective evaluation of corneal curvature changes with 3.0- to 3.5-mm corneal tunnel phacoemulsification. Ophthalmology. 1996; 103: 226-232. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8594506
  3. Weikert MP. Update on bimanual microincisional cataract surgery. Curr Opin Ophthalmol. 2006; 17: 62-67. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16436926             
  4. Wilczynski M, Drobniewski I, Synder A, Omulecki W. Evaluation of early corneal endothelial cell loss in bimanual microincision cataract surgery (MICS) in comparison with standard phacoemulsification. Eur J Ophthalmol. 2006; 16: 798-803. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17191184
  5. Bourne RRA, Minassian DC, Dart JKG, Rosen P, Kaushal S, et al. Effect of cataract surgery on the corneal endothelium; modern phacoemulsification compared with extracapsular cataract surgery. Ophthalmology. 2004; 111: 679-685. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15051198
  6. Weikert MP, Wang L, Barrish J, Dimalanta R, Koch DD. Quantitative measurement of wound architecture in microincision cataract surgery. J Cataract Refract Surg. 2012; 38: 1460-1466. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22814053
  7. Schallhorn JM, Tang M, Li Y, Song JC, Huang D. Optical coherence tomography of clear corneal incisions for cataract surgery. J Cataract Refract Surg. 2008; 34: 1561-1565. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18721720
  8. Torres LF, Saez-Espinola F, Colina JM, Retchkiman M, Patel MR, et al. In vivo architectural analysis of 3.2 mm clear corneal incisions for phacoemulsification using optical coherence tomography. J Cataract Refract Surg. 2006; 32: 1820-1826. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17081864
  9. Calladine D, Packard R. Clear corneal incision architecture in the immediate postoperative period evaluated using optical coherence tomography. J Cataract Refract Surg. 2007; 33: 1429-1435. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17662437
  10. Can I, Bayhan HA, Celik H, Bostanci CB. Anterior segment optical coherence tomography evaluation and comparison of main clear corneal incisions in microcoaxial and biaxial cataract surgery. J Cataract Refract Surg. 2011; 37: 490-500. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21333873
  11. Lyles GW, Cohen KL, Lam D. OCT-documented incision features and natural history of clear corneal incisions used for bimanual microincision cataract surgery. Cornea. 2011; 30: 681-686. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21242779
  12. Fukuda S, Kawana K, Yasuno Y, Oshika T. Wound architecture of clear corneal incision with or without stromal hydration observed with 3-dimensional optical coherence tomography. Am J Ophthalmol. 2011; 151: 413-419e1. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21236408
  13. Xia Y, Liu X, Luo L, Zeng Y, Cai X, et al. Early changes in clear cornea incision after phacoemulsification: an anterior segment optical coherence tomography study. Acta Ophthalmol. 2009; 87: 764-768. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19548882
  14. Teixeira A, Salaroli C, Filho FR, Pinto FT, Souza N, et al. Architectural analysis of clear corneal incision techniques in cataract surgery using Fourier-domain OCT. Ophthalmic Surg Lasers Imaging. 2012; 43(Suppl): S103-108. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23357317
  15. Lee H, Kim EK, Kim HS, Kim TI. Fourier-domain optical coherence tomography evaluation of clear corneal incision structure according to blade material. J Cataract Refract Surg. 2014; 40: 1615-1624.
  16. Wylegala E, Teper S, Nowinska AK, Milka M, Dobrowolski DE. Anterior segment imaging: Fourier-domain optical coherence tomography versus time-domain optical coherence tomography. J Cataract Refract Surg. 2009; 35: 1410-1414. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19631129
  17. Can I, Bayhan HA, Celik H, Bostanc─▒ CB. Anterior segment optical coherence tomography evaluation and comparison of main clear corneal incisions in microcoaxial and biaxial cataract surgery. J Cataract Refract Surg. 2011; 37: 4 90-500. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21333873
  18. Mastropasqua L, Toto L, Vecchiarino L, Di Nicola M, Mastropasqua R. Microcoaxial torsional cataract surgery 1.8 mm versus 2.2 mm: functional and morphological assessment. Ophthalmic Surg Lasers Imaging. 2011; 42:114-124.  PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21323269
  19. Mahdy MA, Eid MZ, Mohammed MA, Hafez A, Bhatia J. Relationship between endothelial cell loss and microcoaxial phacoemulsification parameters in noncomplicated cataract surgery. Clin Ophthalmol. 2012; 6: 503-510. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22536044
  20. Park JH, Lee SM, Kwon J-W, Kim MK, Hyon JY, et al. Ultrasound energy in phacoemulsification: a comparative analysis of phaco-chop and stop-and-chop techniques according to the degree of nuclear density. Ophthalmic Surg Lasers Imaging. 2010; 41: 236-241. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20307043
  21. Marshall J, Trokel S, Rothery S, Krueger RR. A comparative study of corneal incisions induced by diamond and steel knives and two ultraviolet radiations from an excimer laser. Br J Ophthalmol. 1986; 70: 482–501. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/3013283
  22. Taban M, Rao B, Reznik J, Zhang J, Chen Z, et al. Dynamic morphology of sutureless cataract wounds--effect of incision angle and location. Surv Ophthalmol. 2004; 49 (Suppl 2): S62-72. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15028481
  23. Huang D, Swanson EA, Lin CP, Schuman JS, Stinson WG, et al. Optical coherence tomography. Science. 1991; 254: 1178-1181. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/1957169
  24. McDonnell PJ, Taban M, Sarayba M, Rao B, Zhang J, et al. Dynamic morphology of clear corneal cataract incisions. Ophthalmology. 2003; 110: 2342-2348. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/14644716
  25. Fine IH, Hoffman RS, Packer M. Profile of clear corneal cataract incisions demonstrated by ocular coherence tomography. J Cataract Refract Surg. 2007; 33: 94-97. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17189800
  26. Fukuda S, Kawana K, Yasuno Y, Oshika T. Repeatability and reproducibility of anterior chamber volume measurements using 3-dimensional corneal and anterior segment optical coherence tomography. J Cataract Refract Surg. 2011; 37: 461-468. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21333870