In vivo analysis of wound architecture in 700 μm microphakonit cataract surgery

PURPOSE: To analyze the clear corneal wound architecture in 700 mu m cataract surgery (microphakonit) using anterior segment optical coherence tomography (AS-OCT). SETTING: Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. METHODS: Wound architecture was analyzed by AS-OCT 30 minutes after surgery and 1, 3, and 7 days postoperatively in 12 eyes (11 patients) that had microphakonit surgery. Five eyes had microphakonit with a 700 mu m phaco tip with no intraocular lens (IOL) implantation, and 7 eyes had foldable IOL implantation after the main port was extended with a 2.8 mm keratome. RESULTS: Twenty-four clear corneal wounds, which included the main port and the side port, were studied. The mean endothelial misalignment in the microphakonit wound was 0.085 mm +/- 0.09 (SD) immediately postoperatively, 0.057 +/- 0.07 mm at 1 day, 0.020 +/- 0.04 mm at 3 days, and 0.0 mm at 7 days. The mean coaptation loss was 0.030 +/- 0.06 mm immediately postoperatively, 0.029 +/- 0.04 mm at 1 day, and 0.029 +/- 0.04 mm at 3 days. There was a significant positive correlation between the change in stromal hydration and coaptation loss in the 17 wounds without extension; 82.3% of wounds at 3 days and 100% at 7 days had complete endothelial alignment. CONCLUSION: Although there was no significant difference in endothelial misalignment, coaptation loss, or amount of stromal hydration between microphakonit wounds without and wounds with a 2.8 mm keratome extension, wound healing and resolution of coaptation loss or endothelial realignment occurred earlier in wounds without extension.