The Cataract Incision

The Cataract Incision may seem to be a small word in the gamut of ophthalmic terminologies; nevertheless it has a major impact on the wound construction and visual acuity outcome.

After the eye is prepared for surgery, an incision (cut) is carefully made on the edge of the clear cornea. According to the type of surgery conducted the size of the incision varies. Today smaller incisions are possible without any stitches thereby enabling you to quick recovery, fast healing and less likely to get infected.

What are the major considerations in a cataract incision?

  • Location- One of the major factors affecting the degree of astigmatism is the distance of the incision from the center of the cornea, the size of the incision and its shape.
  • Size- Size refers to the area of the wound in terms of its length and width. Smaller the incision lesser the astigmatic effect.
  • Shape- Incisions are made in different shapes according to the favorable factors   e.g. curved, straight, frown, keyhole or chevron.
  • Architecture– Architecture is denoted by the number of incision planes. If the incision construction is not perfect it could lead to endophthalmitis. OCT (Optical coherence tomography) is an instrument used to examine the incision construction and architecture. Incisions in multiple planes ease self sealing thereby reducing the risk of infection.

Incision configuration and manipulation.

Corneal relaxing incisions (Limbal relaxing incisions): These are tiny incisions made on the cornea at precise location to reduce astigmatism.

Features for an ideal incision irrespective of the type of surgery.

  • Postoperative astigmatism – An ideal incision aims in achieving astigmatic ally neutral results.
  • Well balanced – The size and form of the incision gives the fluidic balance during the surgery.
  • Watertight – Watertight incisions avoid leakages and infections and aids faster healing.
  • Stability- The incision should be stable without causing any openings.

Surgeries versus incision size:

  • Standard extracapsular surgery incision size – usually 10-12 mm. has higher risk of infection and takes more healing time.
  • Manual small incision surgery incision size –Usually 5.5 mm to 7.0 mm. clear corneal incisions is one of techniques implemented.
  • Instrumental phacoemulsification incision size– Usually around 2.2 mm. Phase needle and probe is used for the incision.
  • Micro cataract surgery incision size– Usually 1.8mm
  • Femtosecond assisted Laser cataract surgery incision size– Usually 1 mm. In this surgery the flap is made by the laser and multiplanar incisions are repeatable.

The control over Fluidic balance, infection resistance and astigmatism are of paramount importance in any cataract incisions done.

The type of surgery opted and procedure details would be made clear to you prior to your cataract surgery. After a cataract surgery you would be advised to avoid rubbing, forceful blinking or any kind of pressure on the eyes to avoid any damage to the newly made incisions.

With advances in intraocular lens implant and progressive changes in the cataract incisions, you can now experience a painless surgery and obtain faster recovery after a cataract surgery.

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