[Architectural analysis of clear corneal incisions using Visante OCT in acute postoperative endophthalmitis]

To analyze the architecture of clear corneal incisions after acute endophthalmitis following cataract surgery using anterior segment OCT (AS-OCT).

Fourteen eyes of 14 patients followed at the Quinze-Vingts National Ophthalmology Hospital for acute endophthalmitis following cataract surgery, between April and November 2008, were included in this study. All patients had a complete biomicroscopic examination and a Visante-OCT (Carl Zeiss Meditec AG) analysis of the corneal incision. The length, size (width), location, angle, architecture, and anatomic imperfections of the incisions were analyzed.

Symptoms occurred 4+/-2.4 days after cataract surgery. The location of the incision was superior in 71.43% of cases, temporal in 21.43% and nasal in 7.14%. Incision size (width) was 3.2 mm in 42.86% of cases, 2.75 mm in 35.71%, and 3 mm in 21.43%. Two incisions were sutured (14.28%). Using AS-OCT, the mean incision length was 1.42+/-0.25 mm and the mean incision angle was 39+/-10.62 degrees . Three-step incisions were found in 35.71% of cases and endothelial gaping was found in 42.86 % of cases.

A reduced incision length and inappropriate construction seemed to be determinant risk factors of endophthalmitis following cataract surgery. Other studies using a greater number of patients with an architectural analysis of clear corneal incisions are necessary to confirm these preliminary results.