BACKGROUND AND OBJECTIVE: To evaluate wound morphology and integrity using contrast-enhanced spectral-domain optical coherence tomography (SD-OCT). PATIENTS AND METHODS: Eighteen patients (18 eyes) undergoing unilateral routine cataract surgery were enrolled. SD-OCT imaging of the corneal wound was performed immediately following cataract surgery and on postoperative day 1. A topical contrast agent, prednisolone acetate 1%, was used to help evaluate wound integrity. OCT features of the corneal incision and changes in wound interface reflectivity after administration of topical prednisolone acetate 1% were analyzed. Main outcome measures were quantitative and qualitative description of wound morphology and contrast enhancement of the wound interface. RESULTS: Internal wound gape was found in 89% of eyes. Gape area decreased by 43% from days 0 to 1 (462 vs 273 μm(2); P < .01). Contrast enhancement at the wound interface was seen in 56% of eyes on day 0 compared to 17% on day 1 following application of prednisolone acetate 1% (P < .05). Decreased intraocular pressure correlated with increased contrast enhancement (P < .05). CONCLUSION: Wound morphology evolves during the early postoperative period. Wound gape and ingress of a topical contrast agent decrease during the first 24 hours following surgery. Contrast enhancement at the wound interface increases as the intraocular pressure decreases.