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Corneal wound architecture and integrity after phacoemulsification evaluation of coaxial, microincision coaxial, and microincision bimanual techniques.

Publication ,  Journal Article
Berdahl, JP; DeStafeno, JJ; Kim, T
Published in: J Cataract Refract Surg
March 2007

PURPOSE: To compare the effects of microincision bimanual phacoemulsification, standard coaxial phacoemulsification, and microincision coaxial phacoemulsification on clear corneal incision architecture and wound integrity. SETTING: Department of Ophthalmology, Duke University, Durham, North Carolina, USA. METHODS: A prospective study of 15 human cadaver eyes (3 groups of 5 eyes) ranging 1 to 4 days postmortem had simulated phacoemulsification by bimanual phacoemulsification (1.2 mm incision), standard coaxial phacoemulsification (2.75 mm), or microincision coaxial phacoemulsification (2.2 mm). All phacoemulsification settings were kept constant across each group. After phacoemulsification, intraocular pressure (IOP) was cyclically raised and lowered from 0 to 125 mm Hg. Two eyes in each group had India ink placed above the wound, and the IOP was varied as above. Entry of India ink into the wound or aqueous leakage from the wound was recorded. The same 2 corneas in each group were removed for histopathologic review of India ink penetration. Scanning electron microscopy was used to evaluate wound architecture in 1 eye in each group. RESULTS: Spontaneous wound leakage was evident in all 5 eyes having bimanual phacoemulsification, in 1 eye (20%) having standard coaxial phacoemulsification, and no eye having microincision coaxial phacoemulsification. India ink penetration was grossly evident in 2 of 2 eyes having bimanual phacoemulsification, 1 of 2 eyes having standard coaxial phacoemulsification, and neither of the 2 eyes having microincision coaxial phacoemulsification. Scanning electron microscopy showed increased endothelial cell loss and greater compromise to Descemet's membrane with bimanual phacoemulsification than with standard coaxial phacoemulsification or microincision coaxial phacoemulsification. CONCLUSION: Results in this experimental setting suggest microincision coaxial phacoemulsification and standard coaxial phacoemulsification induce less wound stress and alteration of wound morphology leading to wound leakage than microincision bimanual phacoemulsification.

Duke Scholars

Published In

J Cataract Refract Surg

DOI

ISSN

0886-3350

Publication Date

March 2007

Volume

33

Issue

3

Start / End Page

510 / 515

Location

United States

Related Subject Headings

  • Wound Healing
  • Surgical Wound Dehiscence
  • Prospective Studies
  • Phacoemulsification
  • Ophthalmology & Optometry
  • Middle Aged
  • Microsurgery
  • Microscopy, Electron, Scanning
  • Intraocular Pressure
  • Humans
 

Citation

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ICMJE
MLA
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Berdahl, J. P., DeStafeno, J. J., & Kim, T. (2007). Corneal wound architecture and integrity after phacoemulsification evaluation of coaxial, microincision coaxial, and microincision bimanual techniques. J Cataract Refract Surg, 33(3), 510–515. https://doi.org/10.1016/j.jcrs.2006.11.012
Berdahl, John P., John J. DeStafeno, and Terry Kim. “Corneal wound architecture and integrity after phacoemulsification evaluation of coaxial, microincision coaxial, and microincision bimanual techniques.J Cataract Refract Surg 33, no. 3 (March 2007): 510–15. https://doi.org/10.1016/j.jcrs.2006.11.012.
Berdahl, John P., et al. “Corneal wound architecture and integrity after phacoemulsification evaluation of coaxial, microincision coaxial, and microincision bimanual techniques.J Cataract Refract Surg, vol. 33, no. 3, Mar. 2007, pp. 510–15. Pubmed, doi:10.1016/j.jcrs.2006.11.012.
Journal cover image

Published In

J Cataract Refract Surg

DOI

ISSN

0886-3350

Publication Date

March 2007

Volume

33

Issue

3

Start / End Page

510 / 515

Location

United States

Related Subject Headings

  • Wound Healing
  • Surgical Wound Dehiscence
  • Prospective Studies
  • Phacoemulsification
  • Ophthalmology & Optometry
  • Middle Aged
  • Microsurgery
  • Microscopy, Electron, Scanning
  • Intraocular Pressure
  • Humans