gms | German Medical Science

Purpose: To evaluate the efficacy of alternative “roof and floor” hydration technique in comparison with conventional approach by spectral-domain anterior segment optical coherence tomography (SD AS-OCT) images.

Methods: 20 patients underwent phacoemulsification performed by one surgeon, with main incision length – 2.2 mm., prepared by single-use knife (Intrepid® ClearCut Knives, Alcon). There were 2 groups: control group (10 eyes) – conventional hydration technique was used at the end of surgery; study group (10 eyes) – “roof and floor” hydration technique was used for sealing of main incision. Hydrated incision structure was evaluated by SD AS-OCT images made in two planes with AS-OCT Visante (Karl Zeiss Meditec) in 1 hour and 24 hours after surgery.

Surgical technique: Our alternative “roof and floor” technique includes hydration of upper and lower incision lips stroma with specially designed hydrodissection cannula.

Results: In 1 and 24 hours after surgery corneal incisions were sealed in all eyes in both groups. In 1 hour after surgery: Local Descemet membrane detachment was defined in 4 eyes of control group (CG) and in 3 eyes of study group (SG). Endothelial gaping was in 1 case with conventional hydration approach. Endothelial misalignment - in 2 eyes with “roof and floor” hydration and in 1 eye with conventional hydration. In 24 hours after surgery: Local Descemet membrane detachment - in 2 patients of CG and in 1 patient of SG. Endothelial gaping was defined in 1 eye of CG. Endothelial misalignment - in 1 eye with “roof and floor” hydration. Corneal incisions sealing was stable and sufficient during 24 hours after surgery. Thus, there was no significant difference between control and study group in efficacy of two hydration techniques.

Conclusions: “Roof and floor” hydration with specially designed hydrodissection cannula is effective as conventional technique.