Comparative Study of Stromal Hydration in Clear Corneal Phaco Surgery: Hydration of Main and Side Ports Versus Hydration of Side Ports Alone
Narrative Responses:
Purpose
The purpose of this study was to assess and compare the wound integrity after stromal hydration of main and side ports and stromal hydration of only the side ports following 2.6 mm temporal clear corneal incision phacoemulsification with implantation of foldable IOL under topical anesthesia in patients with senile cataracts.
Methods
Eyes were randomly assigned to 2 groups of 30 each. Under topical anesthesia, metal blades were used to create 2.6 mm uniplanar clear corneal temporal incision and 2 uniplanar sideport incisions. Phacoemulsification with implantation of foldable IOL in the bag was performed. In eyes assigned to group A , stromal hydration of main and two sideport wounds was done whereas eyes in group B had stromal hydration of only the two sideport incisions. Integrity of wound was assessed by pressing its posterior lip and Seidel test. Postoperatively, anterior segment OCT pictures were taken to assess wound apposition and any complications.
Results
3 (10%) eyes in group A had a small detachment of Descemet’s membrane away from pupillary area that resolved without intervention. Post hydration, firm pressure on posterior lip of main wound caused leakage in 2 (6.6%) eyes from group A that needed additional hydration, although the Seidel test was negative. In group B, 2 (6.6%) eyes had inadequate apposition of right hand sideport on post-op day 1 as shown on Anterior Segment OCT (ASOCT) probably owing to inadvertent damage while withdrawing the 26 Gauge cystotome. Shallow anterior chamber or post-op endophthalmitis was not encountered in any eye.
Conclusion
Stromal hydration is an effective way of wound closure after clear corneal phacoemulsification surgery. Adequate hydration of sideports alone allows the main 2.6 mm wound to remain competent and water tight without any wound related complications seen till the end of 3 months follow-up.