Dynamics of small-incision clear cornea wounds after phacoemulsification surgery using optical coherence tomography in the early postoperative period

PURPOSE: To evaluate wound dynamics in the immediate postoperative period after phacoemulsification surgery using a small-incision clear cornea approach. METHODS: Eight patients underwent standard postoperative evaluation 24 hours after uneventful phacoemulsification surgery performed through a temporal or nasal clear corneal incision. Additional screening was performed with non-contact optical coherence tomography (Visante Anterior Segment OCT) to examine the corneal wounds. RESULTS: One patient showed partial spontaneous gaping in different areas of the incision, undetected at slit-lamp evaluation. This patient presented with a mild senile bilateral ptosis. Another patient showed localized gaping of the internal aspect of the corneal wound. Both patients had intraocular pressures of 10 mmHg, which were the lowest pressures recorded in the group. Four other incisions showed some degree of localized Descemet's membrane detachment in the vicinity of the wound, also undetected by slit-lamp evaluation. CONCLUSIONS: Small-incision clear cornea wounds may gape in the immediate postoperative period. If the gape occurs along the entire length of the wound, it may lead to inadvertent bacterial access into the anterior chamber. Optical coherence tomography also indicates that localized detachment of Descemet's membrane may be more common than observed with slit-lamp microscopy.