Abstract

Effects of incision angle in construction of clear corneal cataract incision are studied with optical coherence tomography (OCT). A stable incision angle range is found to be existent for single-planed, clear corneal cataract incisions. When well pressurized, incision angles within this stable range result in well-apposed incision edges that resist gapping while incision angles falling outside this range have a larger tendency for wound leakage. It is also shown that a two-planed incision can effectively expand the stable range. For incision angles outside the stable range, the farther the incision angle is away from stable range, the larger the gap between incision wound edges when well pressurized. These findings emphasize the significance of incision construction to the self-sealing property of clear corneal cataract incisions. Finally, we demonstrate that OCT could be an effective modality for imaging and monitoring corneal surgery.

© 2003 Optical Society of America

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References

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  1. Eric J.Linebarger, David R.Hardten, Gaurav K. Shah and Richard L.Lindstrom, "Phacoemulsification and Modern Cataract Surgery," Survey of Ophthalmology 44, 123-147 (1999).
    [CrossRef] [PubMed]
  2. Norregaard JC, Thoning B, Bernth-Petersen P, et al, "Risk of endophthalmitis after cataract surgery: results from the international Cataract Surgery Outcomes Study," Br. J. Ophthalmol. 81, 102-106 (1997).
    [CrossRef] [PubMed]
  3. Somani S, Grinbaum A, Slomovic AR, "Postoperative endophthalmitis: incidence, predisposing surgery, clinical course and outcome," Can. J. Ophthalmol. 32, 303-310(1997).
    [PubMed]
  4. Aaberg TM Jr, Flynn HW Jr, Schiffman J, Newton J, "Nosocomial acute-onset postoperative survey: a 10-year review of incidence and outcomes," Ophthalmology 105, 1004-1010 (1998).
    [CrossRef]
  5. Morlet N, Gatus B, Coroneo M, "Patterns of peri-operative prophylaxis for cataract surgery: a survey of Australian ophthalmologists," Aust. NZJ Ophthalmol 26, 5-12 (1998).
  6. Thomas A.Ciulla, Michael B. Starr, Samuel Masket, "Bacterial Endophthalmitis Prophylaxis for Cataract Surgery,�?? Ophthalmology 109, 13-24 (2002).
    [CrossRef] [PubMed]
  7. Christopher N. Ta, Peter R.Egbert, Kuldev Singh, Erin M. Shriver, Mark S.Blumenkranz, Herminia Mino de Kaspar, "Prospective Randomized Comparison of 3-Day versus 1-Hour Preoperative Ofloxacin Prophylaxis for Cataract Surgery," Ophthalmology 109, 2036-2041 (2002).
    [CrossRef] [PubMed]
  8. Yasunori Nagaki, Seiji Hayaska, Chiharu Kadoi, et al, "Bacterial endophthalmitis after small-incision cataract surgery," J. Cataract Refract. Surg. 29, 20-26 (2003).
    [CrossRef] [PubMed]
  9. Shingleton BJ, Wadhwani RA, et al, "Evaluation of intraocular pressure in the immediate period after phacoemulsification, " J. Cataract Refract. Surg. 27, 1709-1710 (2001)
    [CrossRef]
  10. Percicot CL, Schnell CR, et al, "Continuous intraocular pressure measurement by telemetry in alpha-chymotrypsin-induced glaucoma model in the rabbit: Effects of timolol, dorzolamide, and epinephrine, " J. Pharmacol Toxicol. Methods 36, 223-228 (1996)
    [CrossRef] [PubMed]
  11. Peter J. McDonnell, Mehran Taban, et al, "Dynamic Morphology of Clear Corneal Cataract Incisions," Ophthalmology 110, 2342-2348(2003).
    [CrossRef] [PubMed]
  12. Brett E. Bouma and Guillermo J. Tearney, Handbook of optical coherence tomography (Marcel Dekker 2001).
  13. Hongwu Ren, Zhihua Ding, Yonghua Zhao, Jianjun Miao, Nelson JS, Zhongping Chen, "Phase-resolved functional optical coherence tomography: simultaneous imaging of in situ tissue structure, blood flow velocity, standard deviation, birefringence, and Stokes vectors in human skin," Opt. Let. 27, 1702-1704 (2002).
    [CrossRef]
  14. Jue B, Maurice DM, et al, "The mechanical properties of the rabbit and human cornea", J. Biomechanics 19, 847-853 (1986).
    [CrossRef]
  15. Hoeltzel DA, Atman P, et al, "Strip extensiometry for comparison of the mechanical response of bovine, rabbit, and human corneas, " J. Biomechanical Eng. 114, 202-215 (1992).
    [CrossRef]
  16. Schmitz S, Dick HB, Krummenauer F, Pfeiffer N, "Endophthalmitis in cataract surgery: results of a German survey," Ophthalmology 106, 1869-1877 (1999).
    [CrossRef] [PubMed]

Aust. NZJ Ophthalmol (1)

Morlet N, Gatus B, Coroneo M, "Patterns of peri-operative prophylaxis for cataract surgery: a survey of Australian ophthalmologists," Aust. NZJ Ophthalmol 26, 5-12 (1998).

Br. J. Ophthalmol. (1)

Norregaard JC, Thoning B, Bernth-Petersen P, et al, "Risk of endophthalmitis after cataract surgery: results from the international Cataract Surgery Outcomes Study," Br. J. Ophthalmol. 81, 102-106 (1997).
[CrossRef] [PubMed]

Can. J. Ophthalmol. (1)

Somani S, Grinbaum A, Slomovic AR, "Postoperative endophthalmitis: incidence, predisposing surgery, clinical course and outcome," Can. J. Ophthalmol. 32, 303-310(1997).
[PubMed]

J. Biomechanical Eng. (1)

Hoeltzel DA, Atman P, et al, "Strip extensiometry for comparison of the mechanical response of bovine, rabbit, and human corneas, " J. Biomechanical Eng. 114, 202-215 (1992).
[CrossRef]

J. Biomechanics (1)

Jue B, Maurice DM, et al, "The mechanical properties of the rabbit and human cornea", J. Biomechanics 19, 847-853 (1986).
[CrossRef]

J. Cataract Refract. Surg. (2)

Yasunori Nagaki, Seiji Hayaska, Chiharu Kadoi, et al, "Bacterial endophthalmitis after small-incision cataract surgery," J. Cataract Refract. Surg. 29, 20-26 (2003).
[CrossRef] [PubMed]

Shingleton BJ, Wadhwani RA, et al, "Evaluation of intraocular pressure in the immediate period after phacoemulsification, " J. Cataract Refract. Surg. 27, 1709-1710 (2001)
[CrossRef]

J. Pharmacol Toxicol. Methods (1)

Percicot CL, Schnell CR, et al, "Continuous intraocular pressure measurement by telemetry in alpha-chymotrypsin-induced glaucoma model in the rabbit: Effects of timolol, dorzolamide, and epinephrine, " J. Pharmacol Toxicol. Methods 36, 223-228 (1996)
[CrossRef] [PubMed]

Ophthalmology (5)

Peter J. McDonnell, Mehran Taban, et al, "Dynamic Morphology of Clear Corneal Cataract Incisions," Ophthalmology 110, 2342-2348(2003).
[CrossRef] [PubMed]

Aaberg TM Jr, Flynn HW Jr, Schiffman J, Newton J, "Nosocomial acute-onset postoperative survey: a 10-year review of incidence and outcomes," Ophthalmology 105, 1004-1010 (1998).
[CrossRef]

Thomas A.Ciulla, Michael B. Starr, Samuel Masket, "Bacterial Endophthalmitis Prophylaxis for Cataract Surgery,�?? Ophthalmology 109, 13-24 (2002).
[CrossRef] [PubMed]

Christopher N. Ta, Peter R.Egbert, Kuldev Singh, Erin M. Shriver, Mark S.Blumenkranz, Herminia Mino de Kaspar, "Prospective Randomized Comparison of 3-Day versus 1-Hour Preoperative Ofloxacin Prophylaxis for Cataract Surgery," Ophthalmology 109, 2036-2041 (2002).
[CrossRef] [PubMed]

Schmitz S, Dick HB, Krummenauer F, Pfeiffer N, "Endophthalmitis in cataract surgery: results of a German survey," Ophthalmology 106, 1869-1877 (1999).
[CrossRef] [PubMed]

Opt. Let. (1)

Hongwu Ren, Zhihua Ding, Yonghua Zhao, Jianjun Miao, Nelson JS, Zhongping Chen, "Phase-resolved functional optical coherence tomography: simultaneous imaging of in situ tissue structure, blood flow velocity, standard deviation, birefringence, and Stokes vectors in human skin," Opt. Let. 27, 1702-1704 (2002).
[CrossRef]

Survey of Ophthalmology (1)

Eric J.Linebarger, David R.Hardten, Gaurav K. Shah and Richard L.Lindstrom, "Phacoemulsification and Modern Cataract Surgery," Survey of Ophthalmology 44, 123-147 (1999).
[CrossRef] [PubMed]

Other (1)

Brett E. Bouma and Guillermo J. Tearney, Handbook of optical coherence tomography (Marcel Dekker 2001).

Supplementary Material (2)

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Figures (5)

Fig. 1.
Fig. 1.

Schematic f-OCT setup for imaging corneas

Fig. 2.
Fig. 2.

(1.5 MB) Imaging a 20° two-planed clear corneal cataract incision of human eye.

Fig. 3.
Fig. 3.

(1.97 MB) Imaging a 30° rabbit clear corneal incision of rabbit eye.

Fig. 4.
Fig. 4.

Human corneal incision wounds with incision angles of (a) 90° under 20 mmHg IOP, (b) 90° under 0 mmHg IOP, (c) 55° under 20 mmHg IOP, (d) 55° under 0 mmHg IOP.

Fig. 5.
Fig. 5.

Rabbit corneal incision wounds with angle of (a) 66° under 20 mmHg IOP, (b) 66° under 0 mmHg IOP, (c) 75° under 20 mmHg IOP, (d) 75° under 0 mmHg IOP, (e) 90° under 20 mmHg IOP, (f) 90° under 0 mmHg IOP.

Tables (1)

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Table 1. Effects of Incision Angles

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