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Seidel and India ink tests assessment of different clear cornea side-port incision configurations

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Abstract

Background

Post-cataract endophthalmitis has increased after introduction of clear cornea incisions (CCI). Laboratory models suggested that these incisions might not be competent at certain changes in intraocular pressure (IOP). Considering that side-port incisions (SPI) might behave similarly, the purpose of the present study was to determine the most stable side-port incision configuration.

Methods

Using four cadaveric human eyes, four different side-port incisions (SPI) were created in each cornea: 1.5 mm and 2.5 mm squared tunnel, 1.5 mm and 2.5 mm stab tunnel. Fluorescein was placed on the eye, and the IOP varied from 10 to 80 mmHg. IOP at which each SPI started leaking was recorded. In the second part of the study, India ink was applied to the corneal surface at normal IOP, and then rinsed with balanced salt solution (BSS). The ink influx was recorded by planimetry. IOP was elevated to 80 mmHg, ink was reapplied, and IOP was dropped to 0 mmHg. Ink influx was measured again. Histological examination was used to visualize ink inflow into each incision.

Results

There was no statistically significant difference in the IOP levels at which the different incisions leaked (p = 0.52). A significant increase in the length of India ink ingress in all incision types was measured after IOP variation (p < 0.05). The 2.5 mm squared incision showed the least increase in ink inflow in this test.

Conclusion

All incision types of SPIs tested exhibited similar resistance to leakage after IOP variation. Good resistance to wound leakage may not predict adequate resistance to the inflow of bacterial-sized particles into the wound.

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Acknowledgment

This work supported in part by an unrestricted grant from Research to Prevent Blindness Inc. (New York, NY, USA) to The Wilmer Eye Institute, and by NIH.

Data analyses were supported by Wilmer Biostatistics Core Grant EY01765 NIH/NEI.

Financial disclosure

Authors have no financial interest in any of the devices or drugs used in the study.

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Authors and Affiliations

  1. The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Maumenee 327, Baltimore, MD, USA

    Fabiana K. Kashiwabuchi, Yasin A. Khan, Murilo W. Rodrigues Jr, Peter J. McDonnell & Yassine J. Daoud

  2. Biostatistics Center, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Jiangxia Wang

Authors
  1. Fabiana K. Kashiwabuchi
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  2. Yasin A. Khan
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  3. Murilo W. Rodrigues Jr
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  4. Jiangxia Wang
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  5. Peter J. McDonnell
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  6. Yassine J. Daoud
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Corresponding author

Correspondence to Yassine J. Daoud.

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Authors have full control of all primary data, and we agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review our data upon request.

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Kashiwabuchi, F.K., Khan, Y.A., Rodrigues, M.W. et al. Seidel and India ink tests assessment of different clear cornea side-port incision configurations. Graefes Arch Clin Exp Ophthalmol 251, 1961–1965 (2013). https://doi.org/10.1007/s00417-013-2380-x

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  • DOI: https://doi.org/10.1007/s00417-013-2380-x

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