ENLARGEMENT OF INCISION WIDTH DURING PHACOEMULSIFICATION AND FOLDED INTRAOCULAR-LENS IMPLANT-SURGERY

Purpose: The authors investigated the dimensional stability of incisio ns during phacoemulsification and small-incision intraocular lens (IOL ) implantation. Methods: Forty-six eyes undergoing temporal clear corn eal phacoemulsification and folded silicone IOL implantation were meas ured with an internal-incision gauge after initial keratome entry, cat aract removal, and folded IOL implantation. Results: The initial incis ion created by a diamond keratome was wider than the physical keratome width by a mean of 0.16 mm, After completion of phacoemulsification a nd irrigation/aspiration, the incision further widened by a mean of 0. 09 mm. Both forceps insertion of a three-piece silicone IOL and inject or insertion of a plate haptic silicone IOL resulted in further incisi on enlargement by a mean of 0.26 mm. Widening of the incision before I OL insertion did not eliminate even further incision expansion during the IOL insertion. Conclusions: The phacoemulsification incision enlar ges at each step of the procedure. Irreversible incision stretching or incision tearing occurs, rather than reversible elastic incision defo rmation. Clinical studies that assume the initial keratome size equals the final incision size may be erroneous.