Comparison of wound architecture in implantable collamer lens surgery: Self-sealing single-plane opposite clear corneal incision versus main surgical incision

Abstract

Purpose Incision architecture can play an important role in corneal astigmatism management through peripheral corneal relaxing incisions. The aim of this study was to compare the incision architecture of single-plane opposite clear corneal incisions (OCCIs) and main surgical incisions (MSIs) in patients undergoing implantable collamer lens (ICL) surgery. Methods A retrospective cross-sectional tomographic analysis of MSI and OCCI architectures was performed 6 months after ICL surgery. Image acquisition was performed using spectral-domain anterior segment optical coherence tomography. Results A total of 31 OCCIs and 24 MSIs were evaluated. The mean incision angle was 42.83 ± 5.69 degrees for MSIs and 48.26 ± 6.07 degrees for OCCIs (p < 0.01), and the mean MSI and OCCI length was 1146.70 ± 150.48 µm and 976.68 ± 140.19 µm, respectively (p < 0.01). The mean increase in epithelium depth in the wound was 37.63 ± 11.91 µm in the MSI group and 47.64 ± 15.45 µm in the OCCI group (p = 0.02). Endothelial misalignment was observed in both types of incisions. However, the misalignment with MSI was greater than with OCCI, 106.67 ± 31.84 µm versus 83.75 ± 23.39 µm (p = 0.01), respectively. Conclusion Both types of incisions, OCCI and MSI, were shown to be safe with complete wound sealing and healing 6 months postoperatively. The MSIs performed in the temporal position were more angled and longer, with greater endothelial retraction and minor epithelial thickening in the wound area compared with astigmatic incisions without manipulation.

Management of low astigmatism in implantable collamer lens surgery: opposite clear corneal incisions vs toric implantable collamer lens

“…The results were also widely dispersed in Group 1 (range of corneal SIA between 0.10 and 1.0 D), making this technique less accurate and predictable than T-ICL implantation since correction of corneal astigmatism by manual astigmatic incisions is a multifactorial process. 35,36 In addition, systematic 3.2-mm incisions in Group 1, regardless of the type of astigmatism, together with a temporal main incision may be a distorting factor that should be avoided in future research.…”