Inflammation after sclerocorneal versus clear corneal tunnel phacoemulsification

Area of Science:

• Ophthalmology
• Surgical Innovation
• Clinical Trials

Background:

• Phacoemulsification with intraocular lens (IOL) implantation is a common cataract surgery.
• Sclerocorneal and clear corneal tunnel incisions are surgical approaches for IOL implantation.
• Postoperative inflammation is a key factor influencing visual recovery and patient outcomes.

Purpose of the Study:

• To compare the intensity and duration of postoperative inflammation between sclerocorneal and clear corneal tunnel incisions.
• To evaluate the impact of incision type on the blood-aqueous barrier after cataract surgery.

Main Methods:

• A randomized controlled clinical trial was conducted with 100 patients undergoing phacoemulsification and IOL implantation.
• Patients were randomly assigned to either a temporal sclerocorneal or a clear corneal tunnel incision.
• Laser flare photometry was used to measure anterior chamber flare, an indicator of inflammation, preoperatively and postoperatively.

Main Results:

• The clear corneal tunnel incision group exhibited significantly lower anterior chamber flare at 6 hours, day 1, day 2, and day 3 postoperatively compared to the sclerocorneal group.
• Mean flare levels in the clear corneal group increased from 7.7 to 12.9 at 6 hours and then decreased, while the sclerocorneal group saw an increase from 7.5 to 19.6.
• No statistically significant difference in inflammation was observed between the two groups after 5 months.

Conclusions:

• Clear corneal tunnel incisions result in a statistically significant reduction in early postoperative inflammation following phacoemulsification and IOL implantation.
• The blood-aqueous barrier integrity is better preserved in the early postoperative period with clear corneal tunnel incisions.
• While early inflammation differs, long-term outcomes regarding inflammation appear comparable between the two incision types.