Wound Architecture and Wound Healing after Torsional and Longitudinal Phaco in a Rabbit Model

Carolina Eyecare Physicians, LLCResearch Assistant Professor of Ophthalmology

Storm Eye Institute - Medical University of South CarolinaCharleston, South Carolina

Helga P. Sandoval, MD, MSCR,

Financial Disclosure: HP Sandoval, E Crosswell, K Helke : None. KD Solomon: Alcon , Allergan, AMO , Advanced Vision Research, , Aquesys, Bausch and Lomb, Glaukos, Inspire, LensAR, QLT, Sirion, Wavetec

Co-Authors: Edward Crosswell, MD, Kristi Helke, DVM, PhD, Kerry D. Solomon, MD

None of the Authors has any financial interest in any product mentioned herein.

Purpose

o To determine the effect of incision size in corneal wound healing and architecture after phacoemulsification using longitudinal and torsional phaco in an animal model.

Methodso A total of 40 rabbitso Randomly assigned to one of 4

groups: – Group A, incision size: 1.8mm,

45MFK, Nano-sleeve, Infiniti OZil IP– Group B, 1.8mm ,Stellaris

longitudinal. – Group C, 2.2mm, 45MFK, Ultra-

sleeve, Infiniti OZil IP– Group D, 2.75mm, 45MFK, Micro-

Sleeve, Infiniti OZil IP– To minimize the potential for

variations in surgical technique, each rabbit was intentionally assigned into one of the 4 different groups by the sequential order of the surgeries.

o All surgeries performed by the same surgeon (HPS) using the same clear cornea technique and standardized phaco parameters.

o OD was designated as the study eye (eye undergoing phaco) and OS was used as control.

o Half of the rabbits in each group were sacrificed immediately after surgery (Day 0) and the remaining rabbits were sacrificed 96 hours after the surgery (Day 4).

o Corneas were harvested for scanning electron microscopy (SEM) and histopathology analysis. Results

No significant differences in phaco time, average phaco, estimated fluid used or length of surgery . Daily slit lamp examination did not show differences among the groups.

Results: 1.8 mm Ozil Day 0OD

OS

OD

OS

Results: 1.8 mm Stellaris Day 0OD

OS

OD

OS

Results: 2.2 mm Ozil Day 0OD

OS

OD

OS

Results: 2.75 mm Ozil Day 0OD

OS

OD

OS

OD

OS

Results: 1.8 mm Ozil Day 4OD

OS

OD

OS

Results: 1.8 mm Stellaris Day 4OD

OS

OD

OS

Results: 2.2 mm Ozil Day 4OD

OS

OD

OS

Results: 2.75 mm Ozil Day 4OD

OS

OD

OS

Conclusion

o At day 0, no differences in amount of inflammatory cells were seen between the groups.

o At day 4, 1.8 mm incision with Ozil showed the less amount of inflammation followed by 2.2 mm incision size and 1.8 mm with Stellaris. The 2.75 incision size showed the highest scores of inflammation.

o Similarly, SEM at day 0 shows no differences in wound architecture between the groups but at day 4 is evident that the 2.75 mm incision has not healed compared to the smaller incisions.