Healing changes in clear corneal cataract incisions evaluated using Fourier-domain optical coherence tomography

To evaluate the long-term wound-healing changes in clear corneal cataract incisions using Fourier-domain optical coherence tomography (OCT).

Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA.

Case series.

Multiple OCT images were obtained in consecutive eyes that had phacoemulsification 1 day to 180 months previously. The incision midpoint was measured with OCT. The presence of Descemet membrane detachment, posterior wound gape, and posterior wound retraction was assessed. The depth of wound retraction along the incision and the radial length of the incision were measured. The percentage of wound retraction relative to radial incision length was calculated.

Descemet membrane detachment was present in 37.1% of eyes 1 day postoperatively and in 4.5% of eyes at 1 to 3 months (P=.005); it was absent after 3 months. Posterior wound gape appeared in 85.7% of eyes at 1 day and in 31.8% at 1 to 3 months (P<.001); it was absent after 3 months. Posterior wound retraction appeared in 33.3% of eyes at 2 to 3 weeks, in 75.0% at 1 to 3 years, and in 90.5% after 3 years (P<.001). The mean wound retraction was 120 μm ± 46 (SD) (range 24 to 225 μm), which was 7.5% ± 3.1% (range 2.0% to 13.4%) of the radial incision length.

Descemet membrane detachment and posterior wound gape appeared in the early postoperative period and persisted for up to 3 months, whereas posterior wound retraction developed later and was present in more than 90% of eyes after 3 years, indicating long-term wound remodeling.