Scleral tunnel phacoemulsification: Approach for eyes with severe microcornea

Area of Science:

• Ophthalmology
• Surgical Techniques
• Corneal Surgery

Background:

• Cataract surgery in microcornea eyes presents significant challenges, including corneal edema and posterior capsular rent.
• Existing surgical approaches often lead to frequent complications.

Purpose of the Study:

• To describe and evaluate an improved surgical technique for creating incisions during phacoemulsification in microcornea eyes.
• To assess the safety and efficacy of the scleral pocket incision method in this patient population.

Main Methods:

• Retrospective analysis of eight patients (8 eyes) with cataracts and microcornea.
• Utilized a scleral pocket incision, placed 2.5 mm posterior to the limbus, for phacoemulsification.
• Evaluated postoperative outcomes including corneal edema, intraocular lens implantation, and visual acuity.

Main Results:

• No incidence of port-site peripheral corneal edema was observed.
• Fifty percent of eyes experienced transient central corneal edema.
• Mean best-corrected visual acuity improved significantly from 1.85 LogMAR to 1.26 LogMAR (P = 0.01).

Conclusions:

• The scleral pocket incision technique offers a favorable alternative for cataract surgery in microcornea.
• This posterior incision placement minimizes anterior chamber crowding and reduces complications compared to clear corneal approaches.
• The technique contributes to improved postoperative visual acuity in patients with microcornea and cataracts.