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Force gauge used to test integrity of clear corneal incisions
A calibrated force gauge was used to apply pressure approximating what a patient’s eye might experience when it is rubbed, and then that pressure was used to determine the rate of wound leak after clear corneal incision cataract surgery.
The study authors used the Dontrix gauge (GAC International), modified by Ocular Therapeutix, to determine a force of 1 oz was needed to approximate patient manipulation of the eye. The instrument can be sterilized and used to provide a controlled, quantifiable amount of force, the authors said.
In a study of 30 eyes of 30 subjects, mean IOP increased from 17.49 mm Hg at baseline to 43.44 mm Hg when 1 oz of external force was applied. This confirmed that 1 oz of force can simulate IOP changes associated with eye touching or rubbing or forced blinking.
In a second study, 30 eyes of 29 patients who had undergone clear corneal incision cataract surgery with stromal hydration to seal the main incision were analyzed. Application of 1 oz of force or less resulted in 20 eyes (67%) showing leakage, most from main and side-port incisions.
In a third study, 21 eyes of 21 patients who had undergone clear corneal incision cataract surgery with sutures to seal the main incision were analyzed. Five eyes (23.8%) showed leakage with up to 1 oz of pressure.
The gauge may be useful in testing the integrity of clear corneal incisions shortly after cataract surgery to determine whether leaks are likely, which would allow practitioners to prevent postoperative wound leaks and potential complications, the study authors said.