April 2007

 

CATARACT/ IOL

 

Study investigates the stability of square or nearly square clear corneal wounds


   

A study, published in the March issue of the Journal of Cataract and Refractive Surgery suggests that clear corneal wounds of square or nearly square surface architecture are stable postoperatively.

Samuel Masket, M.D., clinical professor of ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, and colleague assessed the stability of 2.2 mm and 3.0 mm clear corneal cataract incisions with square or nearly square surface architecture. They conducted a retrospective chart review of 60 patients who had clear corneal cataract extraction between January and September 2006. Of the patients, 50 had clear corneal cataract extraction with a square 2.2 mm incision and 10 had a nearly square 3.0 mm incision, the study authors wrote. An unenlarged 2.2 mm clear corneal cataract incision using the Alcon Infiniti (Alcon, Fort Worth, Texas) unit and an Ultrasleeve for infusion were used to accomplished cataract surgery and intraocular lens implantation for the 2.2 mm incision subset, the study authors wrote. And for the 3.0 mm subset, the Allergan Sovereign (Allergan, Irvine, California) unit was used. The study authors reported that intraocular pressure (IOP) was measured intraoperatively at the conclusion of each procedure with a Schiotz (Gulden Ophthalmics, Elkins Park, Penn.) or Barraquer tonometer (Ocular Instruments, Inc., Bellevue, Wash.) and set between 15 mm Hg and 20 mm Hg. In addition, wound sealing was confirmed by intraoperative Seidel testing in all cases. Intraocular pressure was measured by a Tono-Pen (Medtronic Ophthalmics, Jacksonville, Fla.) or Goldmann applanation tonometry between 2 hours and 6 hours after the conclusion of each procedure, the researchers wrote.

The study authors found the mean postoperative IOP to be 19.2 mm Hg +/– 4.9 (SD) (median 18 mm Hg; range 11 to 35 mm Hg) in the group with a 2.2 mm square incision, while the mean postoperative IOP in the group with a 3.0 mm nearly square clear corneal incision was 16.6 +/– 5.2 mm Hg (median 16.0 mm Hg; range 10 to 25 mm Hg). There was no patient with an IOP of less than 10 mm Hg, and there was no evidence of hypotony or wound leakage by Seidel testing in either group, the study authors reported.

The study authors concluded that clear corneal wounds of square or nearly square surface architecture that are meticulously checked for sealing were stable postoperatively as demonstrated by the absence of hypotony and wound leakage. “In the presence of a sealed clear corneal wound, IOP remained reasonably stable relative to the level set at the conclusion of the procedure,” the study authors wrote.

Source: Masket S and Belani S. JCRS 2007: 33(3):383-386.

Reported by: EyeWorld News Staff

       
Study investigates the stability of square or nearly square clear corneal wounds Study investigates the stability of square or nearly square clear corneal wounds
Ophthalmology News - EyeWorld Magazine
283 110
283 110
,
2016-07-26T13:36:19Z
True, 4