Architectural analysis of subconjunctival oblique limbus incision techniques in manual cataract extraction surgery by optical coherence tomography imaging

Indian J Ophthalmol. 2022 Nov;70(11):4036-4040. doi: 10.4103/ijo.IJO_1364_22.

Abstract

The purpose was to assess the profile of subconjunctival oblique limbus incision (SCOLI) design by using anterior-segment optical coherence tomography (AS-OCT) and try to emphasize the proper technique of wound construction. The structural dimensions and integrity of the wound were acquired from the patients, who had undergone manual small-incision cataract surgery with SCOLI techniques, using a Canon OCT anterior-segment imaging system on the first postoperative day. The use of AS-OCT allowed for an in vivo evaluation of SCOLI in high definition. The radial OCT scan image showed three staggered incisions, including conjunctiva incision, scleral entrance, and inner corneal lip. A tangential scan demonstrated that the internal lip is parallel to the curvature of the peripheral cornea. The en face image showed an asymmetric 4 arc-shaped configuration rather than a symmetrical one. In conclusion, AS-OCT could be used to analyze SCOLI to determine optimal wound construction and geometry. The results of this study indicated that an asymmetric 4 arc-shaped limbus tunnel incision was superior to the conventional linear equivalent in stability and nucleus delivery.

Keywords: Anterior-segment optical coherence tomography; incisional funnel; manual small-incision cataract surgery; subconjunctival oblique limbus incisions.

MeSH terms

  • Cataract Extraction* / methods
  • Cornea / surgery
  • Humans
  • Sclera / surgery
  • Surgical Wound* / surgery
  • Tomography, Optical Coherence / methods