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The clear corneal tongue: a mechanism for wound incompetence after phacoemulsification
Diamond Y Tam1, M Reza Vagefi, Ayman Naseri
1Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA.
Purpose:
To describe a mechanism for wound incompetence after phacoemulsification with corneal incisions resulting in early postoperative wound leakage.
Design:
Observational case series.
Methods:
Three patients who had uneventful phacoemulsification through a clear corneal incision were identified because of a postoperative wound leak. A corneal tongue, consisting of an everted triangular flap of posterior corneal stroma, the Descemet membrane, and endothelium, was observed in the wounds of all cases.
Results:
One wound leak resolved after pressure patching. The other two necessitated wound revisions. None of the patients developed endophthalmitis.
Conclusions:
In phacoemulsification with corneal incisions, an everted flap of posterior corneal tissue, a corneal tongue, may prevent normal anatomical apposition of the surgical wound edges leading to potential wound incompetence. This event may increase the risk of endophthalmitis after clear corneal phacoemulsification.
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