జర్నల్ ఆఫ్ ఐ & క్యాటరాక్ట్ సర్జరీ అందరికి ప్రవేశం

నైరూప్య

A Novel Technique to seal leaking phacoemulsification wound

DD Verma Shivani Garg, Ankit Anil Harwani, Diana Carmen Dragnea2

Purpose: To describe a novel technique for sealing of leaking phacoemulsification wound Design: A Prospective, Cross sectional, Observational study. Methods: 100 eyes (100 patients) of age 55 to 70 years, with senile cataract in otherwise normal eyes were included who underwent routine phacoemulsification surgery. 2.8 mm clear corneal phacoemulsification incision was made and foldable intraocular lens was implanted. At the end of surgery, lateral walls over outer two third part of clear corneal wound was hydrated with balanced salt solution. Instead of multiple attempts of wound hydration, we hydrated the wound only once and then waited for 1.5 minutes. Anterior chamber was formed by injecting fluid from side port incision. After that, counter pressure was applied to check any leakage from wound. In this study, intraoperative factors related to need for single versus multiple attempts of hydration were assessed. Also, corneal complications were noted in both the scenarios. Postoperative wound leak, endophthalmitis and visual recovery was also assessed.Results: In 93% of our patients wound sealing was achieved with single attempt of hydration. There was no wound leak on counter pressure at end of the surgery and there was no corneal complications related to hydro sealing of wound in our patients. In remaining 7% of our patients repeat wound hydration was done and wound gets sealed after second attempt. In this 7% of cases either wound architecture was not proper (p value 0.0002) or there was wound burn (p value 0.00001) which lead to inadequate wound sealing after single attempt of hydration. Also, in this subset of patients, intraoperative corneal complications like DMD (p value 0.00001) and excessive corneal edema (p value 0.0042) was observed. Postoperative visual recovery was hastened in group with single attempt of wound hydration, though after 2 weeks both the groups achieved BCVA of 6/6. Postoperatively wound leak and endophthalmitis was not observed in any patient despite either single or multiple attempts of hydration. Conclusion: It is a useful technique to seal leaking phacoemulsification wound in single attempt and also to avoid complications of excessive wound hydration by simple modification (waiting of 1.5minutes before 2nd attempt).