In vivo analysis of wound architecture in 700 microm microphakonit cataract surgery

To analyze the clear corneal wound architecture in 700 microm cataract surgery (microphakonit) using anterior segment optical coherence tomography (AS-OCT).

Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.

Wound architecture was analyzed by AS-OCT 30 minutes after surgery and 1, 3, and 7 days postoperatively in 12 eyes (11 patients) that had microphakonit surgery. Five eyes had microphakonit with a 700 microm phaco tip with no intraocular lens (IOL) implantation, and 7 eyes had foldable IOL implantation after the main port was extended with a 2.8 mm keratome.

Twenty-four clear corneal wounds, which included the main port and the side port, were studied. The mean endothelial misalignment in the microphakonit wound was 0.085 mm +/- 0.09 (SD) immediately postoperatively, 0.057 +/- 0.07 mm at 1 day, 0.020 +/- 0.04 mm at 3 days, and 0.0 mm at 7 days. The mean coaptation loss was 0.030 +/- 0.06 mm immediately postoperatively, 0.029 +/- 0.04 mm at 1 day, and 0.029 +/- 0.04 mm at 3 days. There was a significant positive correlation between the change in stromal hydration and coaptation loss in the 17 wounds without extension; 82.3% of wounds at 3 days and 100% at 7 days had complete endothelial alignment.

Although there was no significant difference in endothelial misalignment, coaptation loss, or amount of stromal hydration between microphakonit wounds without and wounds with a 2.8 mm keratome extension, wound healing and resolution of coaptation loss or endothelial realignment occurred earlier in wounds without extension.