Wound healing of scleral self-sealing incision: a comparison of ultrasound biomicroscopy and histology findings

Purpose: The goal of this study was to compare the morphologic findings of wound healing in scleral self-sealing incisions using ultrasound biomicroscopy and histology. Methods: Using a slit-knife, we made a scleral self-sealing incision in the rabbit eye. At various time points postoperatively, ultrasound biomicroscopy was performed to evaluate wound healing; the eyes then were enucleated and studied histologically. We also performed ultrasound biomicroscopy at various time points postoperatively in patients who received a scleral self-sealing incision during cataract surgery. Results: In rabbit eyes, on days 1 and 2 postoperatively, we detected the scleral wound; thereafter, detection became increasingly difficult. On day 7 postoperatively, the wound was undetectable. By light-microscopic observation, the scleral wound was open at 1 day postoperatively, On day 2 postoperatively, fibrovascular tissue barely extended into the wound; on day 5 postoperatively, connective tissue extended through the full thickness of the wound. On day 7 postoperatively, the connective tissue became dense and aligned with the lamella. In human eyes, using ultrasound biomicroscopy, the scleral incision was detectable until 5 days postoperatively, but undetectable at 7 days postoperatively. Conclusions: Ultrasound biomicroscopy demonstrates the stages of wound healing of scleral self-sealing incisions. We believe that careful observation is necessary for approximately 7 days following self-sealing incision cataract surgery.