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Incision size affects amount of tissue damage in endothelial keratoplasty
Cornea. 2009:28(1):24-31.
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Smaller incision size resulted in more acute tissue damage, no matter which insertion technique was used, in a study of endothelial keratoplasty procedures.
Using 40 precut corneas with normal and abundant endothelium, seven methods of delivering donor tissue were studied, three through a 5-mm incision (forceps with folded tissue, suture pull-through of nonfolded tissue, forceps pull-through of Busin glide folded tissue) and four through a 3-mm incision (forceps with folded tissue, suture pull-through with folded tissue, suture pull-through with nonfolded tissue, forceps pull-through of Busin glide folded tissue). Five corneas were studied in each group, and five corneas were used as controls.
"Other manipulations that may contribute to tissue damage, such as unfolding and tissue positioning, were deliberately not assessed to limit the confounding variables," the study authors said.
Acute endothelial damage done using any technique through a 3-mm incision was significantly greater (36%) than when done through a 5-mm incision (19%) (P < .001).
Damage done by pull-through insertion through a 5-mm incision and that done using forceps insertion through a 5-mm incision were equivalent.