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Sutureless clear corneal incision (CCI) is the most commonly used technique for creating an entrance wound in cataract surgery. Corneal incision hydration enhances wound tightness and reduces postoperative fluid suction from the ocular surface into the anterior chamber; thereby, loweres the risk of postoperative endophthalmitis. Various hydration methods have been employed to close corneal incisions. Standard CCI hydration may be ineffective in sutureless incisions with central wound gaping.
Authors described a new technique of hydration: a posterior flap hydration technique. This study evaluates its effect on corneal wound tightness immediately after hydration, and assess wound architecture on the first postoperative day using anterior segment optical coherence tomography (AS-OCT).
The study subjects are patients with uncomplicated cataracts, without other eye diseases and without diseases affecting wound healing (e.g. diabetes mellitus, rheumatoid arthritis, etc.), who have a visible central wound gap of the CCI at the end of the surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Central wound gap of CCI | Experimental | Patient with visible central wound gap of the CCI were treated with posterial flap hydration. Standard hydrodissection and hydrodelineation cannulas are used for hydration. Cannulas with flat ends, including the cortical cleaving hydrodissector 27 G × 7/8 (BVI Visitec) and a hydrodissector 27 G × 7/8 (Sterimedix Ltd.), are employed. The morphology of the central wound before and after hydration is evaluated using video recordings. On the first postoperative day (20-24 hours after surgery), anterior segment optical coherence tomography (AS-OCT) analysis of corneal incisions is performed with a Tomey Casia 2 device using the Post-op Cataract AS Global Scan application. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Patient with visible central wound gap of the CCI | Procedure | Patient with visible central wound gap of the CCI were treated with posterial flap hydration. Standard hydrodissection and hydrodelineation cannulas are used for hydration. Cannulas with flat ends, including the cortical cleaving hydrodissector 27 G × 7/8 (BVI Visitec) and a hydrodissector 27 G × 7/8 (Sterimedix Ltd.), are employed. The morphology of the central wound before and after hydration is evaluated using video recordings. On the first postoperative day (20-24 hours after surgery), anterior segment optical coherence tomography (AS-OCT) analysis of corneal incisions is performed with a Tomey Casia 2 device using the Post-op Cataract AS Global Scan application. |
| Measure | Description | Time Frame |
|---|---|---|
| posterior flap hydration | The Primary Outcome Measure is to evaluate the tightness of the corneal wound after the posterior flap hydration peroperatively (at the end fo the surgery) - no leakage of the intraocular fluid schould by observed after the hydration. | 1 day after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Corneal wound morphology on the first postoperative day | The other Outcome Measure is the corneal wound morphology on the first postoperative day (20-24 hours after surgery) using anterior segment optical coherence tomography (AS-OCT). The corneal incision pathology (central wound gaping, posterior flap prominence, tongue eversion, tongue retraction and focal Descemet's membrane detachment ) will be serached on OCT pictures and their incidence among study patients will be reported as a percentage (%). |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Pilsen | Pilsen | Czechia | 30100 | Czechia |
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| ID | Term |
|---|---|
| D002386 | Cataract |
| ID | Term |
|---|---|
| D007905 | Lens Diseases |
| D005128 | Eye Diseases |
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| 20-24 hours after surgery |