Bacterial-sized particle inflow through sutured clear corneal incisions in a laboratory human model

Purpose: To determine the effectiveness of a single radial suture placement in 2 clear corneal incision (CCI) configurations in preventing inflow of bacterial-sized particles. Setting: Wilmer Eye Institute, Baltimore, Maryland, USA. Design: Experimental study. Methods: Ten human globes were used. Two 25-gauge needles connected to a saline solution bag and to a digital manometer were inserted through the limbus 120 degrees apart. Four incision-suture combinations were evaluated sequentially in each cornea. All incisions had the same dimensions (2.75 mm width, 3.00 mm length). Two incisions were single plane, and 2 were biplane. One incision from each configuration was left unsutured, and the other was sutured (10-0 nylon). With a preset 10 mm Hg intraocular pressure (IOP), India ink was applied to the incision site and a sudden IOP fluctuation was induced. Inflow was outlined and measured by planimetry. Results: There was a significant increase in area and linear distance of India-ink inflow after pressure challenge in all groups (P<.05), but with important differences among them. When the sutured and unsutured groups from each CCI were compared, there was a significantly smaller area of inflow in the 2-step unsutured group (P<.05). The linear inflow was higher in both sutured groups; however, the difference was significant for the 2-step incision configuration only (P<.05). Conclusions: A single radial suture reduced the area of inflow of bacterial-sized particles but increased the linear distance of inflow in single-plane 3.0 mm incisions. Suture placement in a stepped incision increased inflow of bacterial-sized particles. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.