Objective To compare the architecture and wound edema degree changes of clear-corneal 3.0 mm incisions and 2.2 mm incisions after cataract removal. Methods It was a prospective randomized controlled study. Fifty-eight eyes of 35 age related cataract patients were included and the density of all the cataracts varied from grade Ⅱ to Ⅲ （Emery-Little′s classification）. Patients were randomized to have phacoemulsification through a small-incision （3.0 mm， n=30） or clear corneal microincision （2.2 mm， n=28） by random digital table. Anterior segment optical coherence tomography evaluation was performed at 2 hours， 1 week， 1 month and 3 months after surgery. Incisional corneal thickness and wound architecture， including epithelial gaping， endothelial gaping， local detachment of Descemet′s membrane and loss of coaptation， were assessed. Independent sample t test， nonparametric Wilcoxon rank-sum test and Chi-square test were used for data analysis. Results There was no statistically significant difference in incisional corneal edema degree between 2 groups at all time points. At 2 hours after the surgery， the difference between 2 groups in the occurrence of epithelial gaping， endothelial gaping， local detachment of Descemet′s membrane and loss of coaptation was not statistically significant. At 1 week postoperatively， the incidence of epithelial gaping was higher in the 3.0 mm group than 2.2 mm group and the statistical difference was significant （23% vs 4%， χ²=5.192， P<0.05）. All different morphological incisions in both group recovered at 3 months postoperatively. Conclusion Compared to the traditional small-incisions， the wound morphological characteristics of microincisions might recover faster in the cataracts varying from grade Ⅱ to Ⅲ.
常平骏,丁锡霞,赵云娥,廉恒丽. 白内障超声乳化术后3.0 mm和2.2 mm切口形态的眼前节OCT观察[J]. 中华眼视光学与视觉科学杂志, 2014, 16(8): 456-460.
Chang Pingjun,Ding Xixia,Zhao Yun′e,Lian Hengli. Comparison of 3.0 mm and 2.2 mm clear corneal incision architecture after phacoemulsification of cataract： an anterior segment OCT study. Chinese Journal of Optometry Ophthalmology and Visual science, 2014, 16(8): 456-460. DOI: 10.3760/cma.j.issn.1674-845X.2014.08.003
Crema AS， Walsh A， Yamane Y， et al. Comparative study of coaxial phacoemulsification and microincision cataract surgery. One-year follow-up[J]. J Cataract Refract Surg，2007，33：1014-1018.
[2]
Tong N， He JC， Lu F， et al. Changes in corneal wavefront aberrations in microincision and small-incision cataract surgery[J]. J Cataract Refract Surg，2008，34：2085-2090.
[3]
Can I， Bayhan HA， Celik H， et al. Anterior segment optical coherence tomography evaluation and comparison of main clear corneal incisions in microcoaxial and biaxial cataract surgery[J]. J Cataract Refract Surg，2011，37：490-500.
[4]
Dupont-Monod S， Labbé A， Fayol N， et al. In vivo architectural analysis of clear corneal incisions using anterior segment optical coherence tomography[J]. J Cataract Refract Surg，2009， 35：444-450.
[5]
Cooper BA， Holekamp NM， Bohigian G， et al. Case-control study of endophthalmitis after cataract surgery comparing scleral tunnel and clear corneal wounds[J]. Am J Ophthalmol，2003，136：300-305.
[6]
Monica ML， Long DA. Nine-year safety with self-sealing corneal tunnel incision in clear cornea cataract surgery[J]. Ophthalmology， 2005，112：985-986.
[7]
Taban M， Behrens A， Newcomb RL， et al. Acute endophthalmitis following cataract surgery： a systematic review of the literature[J]. Arch Ophthalmol，2005，123：613-620.
[8]
Fine IH， Hoffman RS， Packer M. Profile of clear corneal incisions demonstrated by ocular coherence tomography[J]. J Cataract Refract Surg，2007，33：94-97.
[9]
Behrens A， Stark WJ， Pratzer KA. et al. Dynamics of small-incision clear cornea wounds after phacoemulsification surgery using optical coherence tomography in the early postoperative period[J]. J Refract Surg，2008，24：46-49.
[10]
Teixeira A， Salaroli C， Filho FR， et al. Architectural analysis of clear corneal incision techniques in cataract surgery using Fourier-Domain OCT[J]. Ophthalmic Surg Lasers Imaging，2012， 43：103-108.
[11]
Cheng B， Liu Y， Liu YZ， et al. Early changes in morphology and intraocular pressure by size of clear corneal incision[J]. Cornea，2011，30：634-640.
[12]
Calladine D， Packard R. Clear corneal incision architecture in the immediate postoperative period evaluated using optical coherence tomography[J]. J Cataract Refract Surg，2007，33：1429-1435.
[13]
Chee SP， Ti SE， Lim LI， et al. Anterior segment optical coherence tomography evaluation of the integrity of clear corneal incisions： a comparison between 2.2-mm and 2.65-mm main incisions[J]. Am J Ophthalmol，2010，149：768-776.
[14]
Ding XX， Chang PJ， Savini G， et al. Clear corneal incision architecture imaging after torsional phacoemulsification of hard nuclear cataract through a 2.2 mm and a 3.0 mm large tunnel[J]. J Clin Exp Ophthalmol，2013，4：279-285.
Taban M， Rao B， Reznik J， et al. Dynamic morphology of sutureless cataract wounds—effect of incision angle and location[J]. Surv Ophthalmol，2004，49：62-72.
[17]
McDonnell PJ， Taban M， Sarayba M， et al. Dynamic morphology of clear corneal cataract incisions[J]. Ophthalmology，2003，110：2342-2348.
[18]
Torres LF， Saez-Espinola F， Colina JM， et al. In vivo architectural analysis of 3.2 mm clear corneal incisions for phacoemulsification using optical coherence tomography[J]. J Cataract Refract Surg，2006，32：1820-1826.
[19]
Calladine D， Tanner V. Optical coherence tomography of the effects of stromal hydration on clear corneal incision architecture[J]. J Cataract Refract Surg，2009，35：1367-1371.
[20]
Sarayba MA， Taban M， Ignacio TS， et al. Inflow of ocular surface fluid through clear cornea cataract incisions： a laboratory model[J]. Am J Ophthalmol，2004，138：206-210.
浙公网安备 33030202001892号