B.MALYUGIN MD,PhD

1
ANTERIOR SEGMENT OCT OF CLEAR CORNEAL INCISIONS
AFTER 1.8mm CMICS AND 2.8mm SANDARD COAXIAL
CATARACT SURGERY

• B.MALYUGIN MD,PhD
• A.GOLOVIN MD

S.FYODOROV EYE MICROSURGERY COMPLEX STATE
INSTITUTION MOSCOW, RUSSIA
FINANCIAL DISCLOSURE B.MALYUGIN Bausch Lomb
Surgical, MST A. GOLOVIN Nothing to disclose
2
PURPOSE TO COMPARE THE STRUCTURE OF THE CLEAR
CORNEAL TUNNELS DONE FOR THE 1.8 mm C-MICS AND
2.8 mm STANDARD CO-AXIAL PHACO USING THE ANTERIOR
SEGMENT OCT
3
MATERIALS METHODS
I-st GROUP 20 EYES (20 PATIENTS)
1.8 mm C-MICS with AKREOS MI60 IOL
II-nd GROUP 20 EYES (20 PATIENTS)
2.8 mm SICS with AKREOS AO IOL
4
MATERIALS METHODS
PHACO SETTINGS
QUICK CHOP IV POLE HEIGHT - 100 cm DUAL LINEAR
FOOTPEDAL CONTROL US POWER LINEAR 30 (max) 80
PPS, 50 DC VACUUM RISE TIME 2 US - 400
mmHg I/A - 600 mmHg
5
MATERIALS METHODS
EVALUATION PARAMETERS CORNEAL THICKNESS,
INCISION LENGTH, ANGLE OF INCISION EVALUATION
INTERVALS 1 DAY, 1 WEEK, 2 WEEKS, 4 WEEKS
POSTOP
6
RESULTS CCI ARCHITECTURE
INTERNAL WOUND ASPECT 1.8 mm C-MICS (n20) 2.8 mm SICS (n20)
ENDOTHELIAL GAPING 5 6
DESCEMET MEMBRANE DETACHMENT 11 10
ENDOTHELIAL SIDE MISALIGNMENT 8 7
7
RESULTS CORNEAL THICKNESS DYNAMICS
EVALUATION INTERVALS CORNEAL THICKNESS (microns) CORNEAL THICKNESS (microns)
EVALUATION INTERVALS 1.8 mm C-MICS 2.8 mm SICS
1st day POSTOP 1.26 0.11 1.06 0.10
1st week POSTOP 0.86 0.05 0.95 0.08
2nd week POSTOP 0.80 0.04 0.79 0.07
4th week POSTOP 0.79 0.06 0.81 0.05
8
RESULTS INCISION ANGLE vs CORNEAL THICKNESS
CHANGES (1st day POSTOP)
1.8 mm C-MICS 1.8 mm C-MICS 2.8 mm SICS 2.8 mm SICS
ANGLE OF INCISION (degrees) 18.65 1.56 23.38 1.35 19.36 1.48 23.76 1.00
CORNEAL THICKNESS (mm) 1.16 0.03 1.35 0.04 1.02 0.06 1.11 0.11
9
CONCLUSIONS

• THERE IS NO SIGNIFICANT DIFFERENCE BETWEEN 1.8 mm
  and 2.8 mm GROUPS IN ENDOTHELIAL MISALIGNMENT AND
  DESCEMET MEMBRANE DEFECTS
• THE PATTERN OF STROMAL HYDRATION IN POSTOPERATIVE
  PERIOD DIFFERS WITH THE SIZE OF THE INCISION
• CORNEAL EDEMA AT THE 1ST POSTOP DAY IN 1.8 mm
  GROUP IS MORE SIGNIFICANT BUT ITS RESOLUTION HAS
  A TENDENCY TO OCCUR EARLIER THAN IN 2.8 mm GROUP
• INCISIONS WITH SHARPER ANGLE OF ATTACK (19 vs 24
  deg.) IN BOTH 1.8 mm and 2.8 mm GROUPS WERE
  FOLLOWED BY LESS STROMAL HYDRATION AND QUICKER
  CORNEAL THICKNESS RECOVERY

10
THANK YOU FOR YOUR ATTENTION

• Boris MALYUGIN MD, PhD
• Andrei GOLOVIN MD