Change of Incision Wound after Folded Intraocular Lens Insertion Through 4.0 and 3.2 mmWidth Scleral Tunnel Incision

ABSTRACT

Two different scleral tunnel incision widths were studied to determine whether the difference of cornea wound extension existed in each scleral tunnel incision widths(4 mm, 3.2 mm).25 patients in group A undergoing phacoemulsification through approximately 4 mmwidth scleral tunnel and folded silicone IOL implantation were studied with internal incision gauge after initial keratome entry, phacoemulsification, and folded IOL implantation. Same procedure was done in group B patients except 3.2 mmscleral tunnel width was made instead. After completion of phacoemulsification, the incision was further widened by a mean of 0.05 mmin both groups. Forceps insertion of silicone IOL resulted in further incision enlargement by a mean of 0.15 mmin group A, and 0.05 mmin group B. No difference was found between the intraoperative or postoperative wound stabilities between two incisions. Vector analysis calculations of mean postoperative induced astigmatism for 4.0 mmincision versus 3.2 mmincision were -0.33D versus -0.20D at 3 month. Therefore, although 4 mmscleral tunnel incision resulted in larger wound extension and induced astigmatism, it showed same wound stability and easier implantation of IOL relative to 3.2 mmscleral tunnel incision. It is necessary that proper scleral tunnel incision width is selected based on degree of surgical skill and compliance of patients.