Clear corneal incisions in bimanual microincision cataract surgery: Long-term wound-healing architecture

PURPOSE: To evaluate bimanual microincision cataract surgery (MICS) clear corneal incision (CCI) architectural features over the long-term using anterior segment optical coherence tomography (AS-OCT). DESIGN: Case series. SETTING: Institute of Ophthalmology, University of Modena, Modena, Italy. METHODS: Patients who had uneventful bimanual MICS in the previous 2 to 16 months were examined using AS-OCT. Images were used to measure corneal thickness, incision length, incision angle, incidence of epithelial or endothelial gaping, misalignment, Descemet membrane detachment, and posterior wound retraction. RESULTS: Fifty-two eyes (33 patients) were enrolled. Mean incision length and incision angle were, respectively, 1427.91 mu m and 31.19 degrees for the right hand, 1440.631 mu m and 31.54 degrees for the left hand, 1474.13 mu m and 31.27 degrees for temporal incisions, and 1394.41 mu m and 31.46 degrees for nasal CCIs. Posterior wound retraction was the only architectural feature found. Its prevalence was 7.10% at 2 to 3 months, 31.8% at 4 to 11 months, and 33.3% at 12 months. Fifty-three percent of posterior wound retractions were in 1.8 mm CCIs and 47% in 1.4 mm CCIs. CONCLUSIONS: Bimanual MICS was not related to particular morphologic features of CCIs. The enlargement of 1 incision or construction of the incision with the dominant or the nondominant hand did not affect long-term wound architecture. Posterior wound retraction was the only architectural feature; however, its prevalence seems substantially lower than with other surgical techniques.