Anterior segment optical coherence tomography evaluation and comparison of main clear corneal incisions in microcoaxial and biaxial cataract surgery

Abstract

Purpose: To use Fourier-domain anterior segment optical coherence tomography (AS-OCT)) to evaluate the main clear corneal incisions (CCIs) in microcoaxial and biaxial cataract surgery, the effects of incision enlargement, and the probable reasons for problematic healing.

Setting: Atatürk Training and Research Hospital, 2nd Ophthalmology Department, Ankara, Turkey.

Design: Cohort study.

Methods: Eyes that had microcoaxial cataract surgery through a 1.8 mm CCI or biaxial cataract surgery through a 1.2 to 1.4 mm trapezoidal CCI were divided into 2 equal subgroups based on incision enlargement. All surgeries were completed by stromal hydration. Incisions were evaluated 1, 8, and 30 days postoperatively.

Results: The CCIs in the microcoaxial group were longer, thinner, and more slanted than those in the biaxial group, with no statistical difference. The microcoaxial incisions had significantly more arcuate configuration at 1 day (P=.003); however, the configuration became linear in the following days in both groups. The endothelial gap rates were less and Descemet membrane detachment rates greater than reported in the literature. In eyes with enlarged CCIs, the endothelial gap rate was higher in the microcoaxial group and the Descemet membrane detachment rate was higher in the biaxial group (both P=.05). At 1 day, the intraocular pressure (IOP) was significantly lower in Descemet membrane detachment and endothelial gap cases (P=.006 and P<.001, respectively).

Conclusions: Although closure was reliable in both groups, the microcoaxial group had slightly fewer undesirable effects on the incision site. Low postoperative IOP seemed to be a significant factor in problematic healing.