Benefits of stromal hydration

Vasavada, Abhay R.; Mamidipudi, Praveen R.; Gajjar, Devarshi; Vasavada, Vaishali; Raj, Shetal M.

doi:10.1016/j.jcrs.2009.12.014

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…This risk of a leaky wound including endophthalmitis, corneal edema, hypotony and lens displacement far outweigh problems associated with stromal hydration such as localized descemet’s detachment and incision elongation. [ 3 8 ] Even though the wound appears well sealed at the end of surgery, and there is no apparent hypotony in the immediate postoperative period, patient manipulations such as inadvertent rubbing have been shown to raise IOP and cause leakage in 67% of eyes. [ 4 9 ] The higher rate of endophthalmitis after widespread adoption of temporal clear corneal incisions also lend credence to this theory that transient wound leakage occurs in more eyes than we estimate.…”

Section: Discussionmentioning

confidence: 99%

Wound integrity of modified anterior stromal hydration Vs. conventional hydration after clear corneal incision phacoemulsification

Lohmror

Sharma

Kalia

2021

Indian Journal of Ophthalmology

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Purpose: To compare the self-sealing ability of temporal clear corneal incisions for phacoemulsification using conventional stromal hydration (CH) with two modified methods: the anterior stromal pocket hydration (ASPH) and the modified stromal pocket hydration (MASH). Methods: Patients undergoing routine phacoemulsification surgeries were randomized to receive the CH, ASPH, and MASH ( n = 30 eyes in each group). In the ASPH, an anterior stromal pocket was created superficial and parallel while in the MASH; it was superficial and perpendicular to the plane of the main incision. The primary outcome measure was wound leakage assessed after applying firm downward pressure on the posterior lip of the main corneal incision, simulating eye rubbing. Results: On application of pressure to the posterior lip, leakage was seen from 19 eyes (63%) in the CH group, while this was seen in only two eyes (7%) each in the ASPH and MASH groups ( P < 0.001). The likelihood of wound leak after applying pressure to the posterior lip reduced by 86% in the ASPH and MASH groups compared to CH (Odds ratio = 0.14, 95% CI = 0.05 – 0.35, P < 0.001). The mean surgically induced astigmatism was 0.18 ± 0.14D and there were no differences in SIA across the three groups ( P = 0.42). More eyes in the ASPH required conversion to CH ( n = 4, 13%) due to difficulty in localizing the pocket compared to MASH ( n = 0, P = 0.03) Conclusion: Both, the ASPH and MASH techniques reduce the risk of wound leakage and do not induce astigmatism. The MASH technique makes it easier to consistently localize the pocket.

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Section: Discussionmentioning

confidence: 99%

Wound integrity of modified anterior stromal hydration Vs. conventional hydration after clear corneal incision phacoemulsification

Lohmror

Sharma

Kalia

2021

Indian Journal of Ophthalmology

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“…There have been ongoing discussions in the literature around the merits of this technique 6,7,14–19. In a study involving 80 eyes that received 2.2 mm incisions, Vasavada and colleagues reported a reduced ingress of trypan blue that had been instilled on the ocular surface 6.…”

Section: Discussionmentioning

confidence: 99%

The effect of stromal hydration on surgical outcomes for cataract patients who received a hydrogel ocular bandage

Walters¹

2011

OPTH

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Purpose:The purpose of this study was to examine the effect of stromal hydration on surgical outcomes for patients who received the new hydrogel ocular bandage (ReSure™ Adherent Ocular Bandage, Ocular Therapeutix, Inc, Bedford, MA, USA) following routine cataract surgery.Methods:This post-hoc, single-masked study was conducted with 310 patients who were scheduled to undergo unilateral clear corneal cataract surgery with phacoemulsification and intraocular lens implantation. Incisions were closed with stromal hydration (270 patients) or without stromal hydration (40 patients) based on physician standard of care. All patients received the hydrogel bandage at the conclusion of the procedure. Ocular assessments of stromal edema, flare, corneal staining, anterior chamber cells, best-corrected visual acuity, and intraocular pressure were made 24 hours after surgery.Results:Significantly more patients experienced stromal edema in the group with stromal hydration (26.3% versus 10.0%, respectively; P = 0.028). A higher percentage of patients experienced corneal staining when stromal hydration was performed (20.4% versus 2.5%; P = 0.004). The mean BCVA (best-corrected visual acuity) also was significantly different between the groups (logMAR of 0.164 with stromal hydration versus 0.095 without hydration; P = 0.007). No significant differences were observed between the study groups in terms of flare, anterior chamber cells, or intraocular pressure.Conclusion:Cataract surgery without stromal hydration provided better surgical outcomes than the traditional hydration procedure when used in conjunction with a new hydrogel bandage.

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