Comparison of 2.2 mm vs 2.8 mm clear corneal wound characteristics following wound assisted IOL injection

This study aims to evaluate wound extension, IOL safety, Descemet membrane detachment and surgically induced astigmatism in phacoemulsification surgery using the wound assisted technique of IOL implantation and to study their relationship with incision size.

This will be a prospective, observational study conducted at Aravind Eye Hospital, Chennai. All surgeries will be performed by 4 experienced surgeons, using the Centurion Phacoemulsification system under topical or sub-Tenon’s anaesthesia. Surgery will be performed via standard clear corneal incisions of either 2.2mm or 2.8mm size depending on the intraocular lens that the patient has chosen. Once the cataract has been removed from the eye, the incision size will be measured by a device called incision gauge. Following this, the IOL will be injected through this incision inside the eye. The surgeon will once again measure the incision size after this step. The surgery would be concluded as usual. In the event of detecting any nicks, scratches or breaks of the intraocular lens (IOL) during its insertion, their presence will be duly observed and documented by the surgeon. ASOCT will be done for all patients to analyse wound size, wound gape and non-apposition of the incision and detect the presence of Descemet membrane detachment on post-operative day 1 and post-operative day 21. Biometry will be done for all participants pre-operatively, on post-operative day 21 and on post-operative day 90 to check for keratometry and surgically induced astigmatism.