Corneal Wound Architecture and Integrity After Torsional and Mixed Phacoemulsification: Evaluation of Standard and Microincisional Coaxial Techniques

Abstract

To compare the effects of torsional and mixed ultrasound on clear corneal incision architecture, wound integrity, and apposition using standard (2.75 mm) and microincisional (2.2 mm) coaxial phacoemulsification. Twenty human cadaver eyes (4 groups of 5 eyes) underwent simulated coaxial phacoemulsification for 45 seconds of ultrasound time (group 1 = 2.75 mm, 100% torsional; group 2 = 2.2 mm, 70% torsional; group 3 = 2.2 mm, 100% torsional; group 4 = 2.2 mm, mixed ultrasound). All phacoemulsification settings were kept constant across each group. Following phacoemulsification, intraocular pressure (IOP) was cyclically raised and lowered from 0 to 125 mm Hg. Two eyes from each group had India ink placed over the wound and were observed for leakage and for histopathologic examination. Eyes not exposed to India ink (three eyes of each group) were examined using anterior segment optical coherence tomography (OCT) and scanning electron microscopy (SEM). Wound leakage was evident in one eye from group 1 and no eyes from the other three groups. Histopathologic examination revealed no India ink penetration in any of the eyes studied. Anterior segment OCT showed good wound apposition in each group. SEM demonstrated partially compromised endothelium and Descemet's membrane in all eyes studied from each group. No differences in corneal wound architecture and integrity were observed. Torsional and mixed ultrasound settings do not appear to induce any adverse effects on corneal wound architecture and integrity in standard and microincisional coaxial phacoemulsification techniques.