Standardized Seidel test to evaluate different sutureless cataract incision configurations.

Area of Science:

• Ophthalmology
• Surgical Innovation
• Ocular Microbiology

Background:

• Clear corneal incisions (CCIs) are crucial in modern cataract surgery.
• Accurate assessment of CCI integrity is vital to prevent postoperative complications like endophthalmitis.
• The Seidel test is commonly used to evaluate wound leakage, but its predictive accuracy for bacterial invasion is debated.

Purpose of the Study:

• To compare aqueous outflow and India ink inflow in human donor corneas with different clear corneal incision (CCI) designs.
• To evaluate the reliability of the Seidel test in predicting wound integrity and potential for bacterial ingress.

Main Methods:

• Three types of 2.75 mm wide CCIs were created in human donor corneas: 1.5 mm single-plane tunnel, 3.0 mm single-plane tunnel, and 3.0 mm 2-step tunnel.
• The Seidel test was performed at various intraocular pressures (IOPs).
• India ink inflow was measured using planimetry after inducing IOP fluctuations to assess wound leakage and potential for microbial entry.

Main Results:

• All 1.5 mm single-plane incisions showed India ink inflow and outflow.
• 3.0 mm single-plane incisions showed inflow in all cases, with 2/6 exhibiting outflow.
• 3.0 mm 2-step incisions had less India ink inflow and positive Seidel test results in 3/6 cases.
• Inflow area and length were significantly greater in single-plane incisions compared to 2-step incisions.

Conclusions:

• The study utilized an ex vivo human cornea model to assess CCI integrity.
• Results indicate that wound deformation observed during Seidel testing may not be a reliable predictor of bacterial invasion risk in the early postoperative period.
• Further research is needed to refine methods for assessing CCI security and preventing microbial contamination.