Renata T. Kashiwabuchi

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.

Sutured clear corneal incision: wound apposition and permeability to bacterial-sized particles.

Purpose: To determine the effects of single radial or horizontal suture placement in 2-step clear corneal incision (CCI) wound apposition and permeability to particles of India ink. Methods: Five fresh human globes were included. Two 25-gauge needles connected to a saline solution bag and to a digital manometer were inserted through the limbus, 120 degrees apart from each other. Four 2-step CCIs (2.75 mm wide and 3 mm length) were constructed in each cornea. Incisions were divided into 3 groups: single radial suture (SRS), single horizontal suture (SHS), and unsutured group. Optical coherence tomography (OCT) was performed before and after suture placement. With a preset 10 mm Hg intraocular pressure (IOP), India ink was applied to the incision site and a standardized sudden IOP fluctuation was induced. OCT and superficial images were recorded before and after suture placement. India ink inflow and internal and external CCI gapping were outlined and measured by planimeter. Results: The area and linear distance of India ink inflow after pressure challenge in all study groups were higher when compared with pre-pressure measurements; however, this increase was significant in the SRS and SHS groups (P < 0.05). Additionally, SRS placement significantly increased inner wound gapping (P = 0.018), and SHS significantly widened outer wound gape (P = 0.02). Conclusions: Well-constructed unsutured 2-step CCI seems to be more efficient at preventing bacterial-sized particles inflow during sudden changes in IOP, and it seems to offer better wound apposition as assessed by OCT.

Evaluation of phacoemulsification‐induced oxidative stress and damage of cultured human corneal endothelial cells in different solutions using redox fluorometry microscopy

Acta Ophthalmol. 2010: 88: e323–e327