Sutured Clear Corneal Incision: Wound Apposition and Permeability to Bacterial-Sized Particles

Sutured Clear Corneal Incision: Wound Apposition and Permeability to Bacterial-Sized Particles

Author May, William N. Google Scholar
Castro-Combs, Juan Google Scholar
Kashiwabuchi, Renata T. Google Scholar
Tattiyakul, Woranart Google Scholar
Qureshi-Said, Saima Google Scholar
Hirai, Flavio Autor UNIFESP Google Scholar
Behrens, Ashley Google Scholar
Institution Univ So Calif
Johns Hopkins Univ
Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose: To determine the effects of single radial or horizontal suture placement in 2-step clear corneal incision (CCI) wound apposition and permeability to particles of India ink.Methods: Five fresh human globes were included. Two 25-gauge needles connected to a saline solution bag and to a digital manometer were inserted through the limbus, 120 degrees apart from each other. Four 2-step CCIs (2.75 mm wide and 3 mm length) were constructed in each cornea. Incisions were divided into 3 groups: single radial suture (SRS), single horizontal suture (SHS), and unsutured group. Optical coherence tomography (OCT) was performed before and after suture placement. With a preset 10 mm Hg intraocular pressure (IOP), India ink was applied to the incision site and a standardized sudden IOP fluctuation was induced. OCT and superficial images were recorded before and after suture placement. India ink inflow and internal and external CCI gapping were outlined and measured by planimeter.Results: the area and linear distance of India ink inflow after pressure challenge in all study groups were higher when compared with pre-pressure measurements; however, this increase was significant in the SRS and SHS groups (P < 0.05). Additionally, SRS placement significantly increased inner wound gapping (P = 0.018), and SHS significantly widened outer wound gape (P = 0.02).Conclusions: Well-constructed unsutured 2-step CCI seems to be more efficient at preventing bacterial-sized particles inflow during sudden changes in IOP, and it seems to offer better wound apposition as assessed by OCT.
Keywords cataract surgery
clear corneal incision
Language English
Sponsor May Vision Foundation, Los Angeles, California
Research to Prevent Blindness, New York, New York
Johns Hopkins University School of Medicine, Baltimore, Maryland
Research to Prevent Blindness Althouse Special Scholars Award
Fight for Sight, New York, New York
Date 2013-03-01
Published in Cornea. Philadelphia: Lippincott Williams & Wilkins, v. 32, n. 3, p. 319-325, 2013.
ISSN 0277-3740 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 319-325
Access rights Closed access
Type Article
Web of Science ID WOS:000314818700017

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