Early changes in clear corneal incision after phacoemulsification by anterior segment optical coherence tomography / Heldz Abdelgayyed Abdelrahman Khalil ; Supervised Ahmed Bahey Eldin Shalash , Hebat-Allah Abdelrahman Elgendy , Radwa Taher Alzanaty

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Ophthalmology

Objective: To study the ultrastructure of clear corneal main incision of phacoemulsification , using Anterior Segment Optical Coherence Tomography and to compare between the superior and the temporal approach . Design: Prospective non randomized comparative study. Methods: The study included sixty eyes of immature senile cataract that underwent phacoemulsification and IOL implantation.Thirty eyes were done using the superior approach and the other thirty , using the temporal approach. OCT was done 1 day and 6 weeks postoperatively.Wound architecture and healing were studied in both groups and comparison was done between them . Pre , post and intraoperative data were documented i.e (BCVA, IOP, density of cataract,US power and time) and included in the statistical analysis to detect if there were any perioperative predictive factors for the final outcome. Results: Mean corneal thickness in the first postoperative day at the incision site was higher in the temporal group with a significant statistical difference.The incision length was shorter in the temporal group with a larger angle than the superior group with a significant statistical difference as well . Incidence of endothelial changes (gaping and misalignment ) was higher in the temporal group than the superior group in both follow up visits. Descemet membrane detachment and epithelial gaping completely healed in the 2nd follow up visit in all eyes of both groups.Finally, wound healing was faster in the superior incision than the temporal incision with a significant statistical difference. Age, US power ,US time and IOP have been noted to affect corneal wound architecture and healing

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