Profile of clear corneal cataract incisions demonstrated by ocular coherence tomography

To examine the profile of clear corneal cataract incisions in the living eye using optical coherence tomography (OCT).

Private practice, Eugene, Oregon, USA.

The Zeiss Visante OCT anterior segment imaging system was used to study the profile of clear corneal cataract incisions, all in senior citizens. The OCT images of the operative eye were taken on the first postoperative day approximately 24 hours after surgery. The OCT images of clear corneal incisions were compared with an OCT image of a control eye, incisions without stromal hydration, and previous drawings of clear corneal incisions.

In the images, the clear corneal incisions had an arcuate configuration rather than a straight line configuration, as previously indicated. This architecture appears to add greater stability as a result of a tongue-and-groove-like fit of the floor to the roof of the incision as well as an incision that is longer than the chord length that had previously been measured. Other findings include that stromal swelling, which facilitates sealing of these incisions by the endothelial pump, lasted for at least 24 hours.

Results indicate an incision in the plane of the cornea with a chord length of at least 2.0 mm provides advantageous architecture for adequate self-sealing. Proper clear corneal incision construction resulted in an incision architecture that seemed to have increased stability and added safety, contributing to an absence of endophthalmitis for more than 10 years and 9000 cases in a single practice.