Comparison of stromal hydration techniques for clear corneal cataract incisions: Conventional hydration versus anterior stromal pocket hydration

Abstract

Anterior stromal pocket hydration was compared with conventional hydration for preventing wound leak after 2.8 mm uniplanar clear corneal incisions (CCIs) in patients having routine cataract surgery. Conventional hydration involves hydration of the lateral walls of the main incision with visible whitening of the stroma. The anterior stromal pocket hydration technique involves creation of an additional supraincisional stromal pocket overlying the main incision, which is then hydrated instead of the main incision. Sixty-six eyes of 48 patients were included in the data analysis with 33 assigned to each study group. The anterior stromal pocket hydration technique was significantly better than conventional hydration in preventing wound leak due to direct pressure on the posterior lip of the incision.

Irrigation port hydration in phacoemulsification surgery

“…Nithyanandarajah et al7 reported a technique for sealing clear corneal incisions using a 30-gauge needle and injection of a balanced salt solution into the anterior stroma above the incision. Mifflin8 described finding that the anterior stromal pocket hydration technique was significantly better than conventional hydration in preventing a wound leak due to the direct pressure on the posterior lip of the incision. Thus, it appears that these procedures are effective in terms of strengthening the construction of the incision wounds.…”

Structural Analysis of Different Incision Sizes and Stromal Hydration in Cataract Surgery Using Anterior Segment Optical Coherence Tomography

“…Stromal hydration is characterized by the lateral walls of the main incision with visible whitening of stroma. Although corneal endothelium apparently absolves water content of stromal hydration [ 11 ], a complete understanding of the incisional dynamics in cataract surgery is lacking [ 9 , 12 , 13 , 14 , 15 ]. These results imply the process of corneal wound recovery may be intensified and expedited by pumping water onto the corneal endothelium via stromal hydration.…”

Conventional versus anterior stromal pocket hydration

“…In their recent article, García-L azaro et al 1 provide metrics of visual function at different object vergences in patients wearing 4 contact lens-based artificial pupil designs in the nondominant eye. They state that a basic objective of their study was to provide a surrogate model for the Acufocus Kamra intracorneal inlay.…”

“…2 Therefore, balanced salt solution injected during the conventional technique might reach the posterior corneal layers, causing them to expand; this expansion could limit the effect on wound stabilization. In contrast, during anterior stromal hydration as described by Mifflin et al, 1 the balanced salt solution would tend to remain in the anterior corneal layers, which would resist further expansion. The pressure on the wound would be greater, creating a better watertight closure.…”

“…The article by Mifflin et al 1 comparing 2 techniques of stromal hydration during routine cataract surgery requires further discussion. According to the authors' conclusions, anterior stromal hydration is better because it exerts direct pressure on the posterior lip of the incision.…”