The pocket can be created either with a keratome or with a femtosecond laser. 1 This term refers to creation of an extra nonpenetrating incision anterior to the main wound that, when stromal hydration is applied, puts downward pressure on the main wound to achieve good wound closure. A modification of traditional stromal hydration is the Wong pocket. Stromal hydration should be employed in the main corneal incision and the sideport incisions. Postoperative corneal OCT has demonstrated that the effects of stromal hydration can last up to 1 week postoperatively. The hydration is a temporizing measure until the corneal endothelial pump can further seal the incision. Stromal hydration swells the corneal lamellae, forcing them to abut and close the incision. It is typically employed by delivering balanced salt solution via a 30-gauge cannula into the corners and internal roof of the incision. Stromal hydration is an effective means to stem the leakage from most spontaneously leaking cataract incisions. STROMAL HYDRATIONĪt the conclusion of surgery, the wound can be examined for competence by application of fluorescein, gentle indentation of the proximal sclera, or visual inspection after drying with a cellulose sponge (Weck-Cel, BVI). If it is too long, the length of the tunnel may lead to intraoperative striae or oar-locking of instruments.
If the incision is too short, the wound may be incompetent. A wound length of 1 to 2 mm is recommended to ensure adequate wound closure. It can be created with a diamond or steel keratome or with a femtosecond laser. The self-sealing clear corneal temporal wound typically incorporates both horizontal and vertical components. In the era of refractive cataract surgery, a well-constructed, astigmatically neutral wound is necessary to achieve the planned refractive visual outcome and satisfy the patient.
Furthermore, a competent wound prevents postoperative ingress of bacteria that can result in endophthalmitis. Sealing the microincision at the conclusion of cataract surgery is crucial to maintaining the structural integrity of the eye and preventing complications due to wound leakage such as hypotony, corneal edema, and IOL dislocation. Laser-Target Your Marketing With Patient Avatars Maintaining Proper Anterior Chamber PressureĬortical Removal and Handling Cortical Adhesions Pupil Expansion Techniques in Cataract Surgery Preparing and Draping the Eye for Anterior Segment Surgery LASIK in the Face of Negative News CoverageĪggressive Recurrent Inflammation After LASIKīig Data and the AAO IRIS Registry Partnership With Verana Health
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